Type Four AVM

In the final type of AVM, perimedullary lesions, intradural-extramedullary arteriovenous communications between the anterior and the posterior spinal arteries and perimedullary veins belonging to the coronal venous plexus, develop. These lesions are usually located on the lateral or ventral aspect of the spinal cord.

Clinical presentation. Patients usually present with progressive neurological deficits involving the cauda equina or the conus. Some patients present with subarachnoid hemorrhage of a sudden onset.

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