These may present clinically at any age; males are affected more frequently than females.
The majority - 85-90% - present gradually. Features arise from increased venous pressure, venous thrombosis, arachnoiditis from an earlier bleed, or 'steal' phenomena. Presentation is of a progressive neurological disability with paresis, sensory disturbance, sphincter dysfunction, and possibly, impotence. There is back pain and root pain.
AVM's in the thoracolumbar region commonly produce a mixed upper and lower motor neurone weakness in the legs. Intramedullary lesions may resemble the picture of intermittent claudication.
A smaller number present with a more acute picture. Most are due to subarachnoid haemorrhage and may be accompanied by headache, neck stiffness, back and leg pain. Other causes include extradural, subdural and intramedullary haematoma.
Spinal bruits and midline cutaneous lesions - haemangiomas, naevi or angiolipomas - may be found.
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