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Paraplegia in Pregnancy: A Case of Spinal Vascular Malformation With Klippel–Trenaunay Syndrome

Demir, Caner Feyzi MD*; Yildiz, Mustafa MD; Özdemir, Hasan MD*; Kapan, Oktay MD*; Bozgeyik, Zülkif MD; Berilgen, Said MD*; Aygün, Banu MD§; Erol, Fatih Serhat MD

doi: 10.1097/BRS.0b013e31825c66ab
Case Report

Study Design. A case report.

Objective. To present improvement of paraplegia due to spinal vascular malformation after delivery with no intervention.

Summary of Background Data. Pregnancy has been reported rarely in patients with Klippel–Trenaunay syndrome (KTS). A combined case of spinal arteriovenous malformations (AVMs) within KTS has not been reported before.

Methods. A case report of KTS with paraplegia is presented and the pertinent literature is then reviewed.

Results. A pregnant woman who was diagnosed with KTS in childhood presented with newly developed paraplegia due to spinal AVMs. Magnetic resonance image showed a vascular malformation at the T9–T12 levels without evidence of spinal cord hemorrhage. Diagnostic angiography that was performed after delivery revealed a high-flow arteriovenous fistula with AVM.

Conclusion. Pregnancy complicated by paraplegia is thought to be secondary to venous engorgement and to the resulting spinal cord ischemia in this case. Her neurological symptoms and signs gradually improved over the few days after cesarean delivery.

A combined case of spinal arteriovenous malformations (AVMs) within Klippel–Trenaunay syndrome (KTS) in a pregnant woman who diagnosed with KTS in childhood presented with newly developed paraplegia because of spinal AVMs. Pregnancy complicated by paraplegia is thought to be secondary to venous engorgement and to the resulting spinal cord ischemia in this case.

Departments of *Neurology

Emergency

Radiology

§Obstetrics and Gynaecology

Neurosurgery, Firat (Euphrates) University, Elazig, Turkey.

Address correspondence and reprint requests to Caner Feyzi Demir, MD, Department of Neurology, Firat (Euphrates) University Hospital, 23119 Elazig, Turkey; E-mail: cfdemir@gmail.com

Acknowledgment date: January 12, 2012. First revision date: February 29, 2012. Second revision date: April 3, 2012. Acceptance date: April 20, 2012.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2012 Lippincott Williams & Wilkins, Inc.