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A. Mironov, C. Rossberg, Armin K. Thron (Beteiligte)

Vascular Anatomy of the Spinal Cord


Neuroradiological Investigations and Clinical Syndromes
Mitarbeit: Rossberg, C.; Mironov, A.
Softcover reprint of the original 1st ed. 1988. 2011. vii, 114 S. VII, 114p. 74 illus.. 279 mm
Verlag/Jahr: SPRINGER, WIEN; SPRINGER, BERLIN 2011
ISBN: 3-7091-7446-5 (3709174465)
Neue ISBN: 978-3-7091-7446-3 (9783709174463)

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The idea for this treatise on the radiological anatomy of superficial and deep spinal cord vasculature evolved from daily routine neuroradiological work. This was also the reason for subdividing the monograph into a postmortem anatomical and a clinical part. The actual importance of a clear conception of radio anatomic fundamentals was made clear by many clinical conferences with neurologists, neurosurgeons and orthopedists, where a lack of knowledge about medullary syndromes of suspected vascular origin became evident. Also among neuroradiologists there is still widespread uncertainty in the interpretation of myelograms and angiographies in such cases. A study of the spinal cord´s angioarchitecture is all the more justified and necessary considering the vast number of descriptions of cerebro vascular anatomy and pathology. The clinical challenge posed by patients suffering from partial or complete transverse spinal lesions has grown due to new diagnostic and therapeutic approaches. Myelography using water-soluble contrast media, X-ray computed tomography, magnetic resonance imaging and spinal angiography today allow and require both earlier and topographically and pathogenetically more exact classification of diseases of the spinal cord and its surrounding structures. Due to progress in microneurosurgery and interventional neuroradiology, even intramedullary lesions have become more and more accessible and treatable. Therefore this monograph mainly addresses those concerned with invasive therapeutic techniques and who are familiar with the interpretation of radio anatomic findings. A comprehensive description of medullary vascular syndromes would be beyond the scope of this treatise.
I. Introduction.- II. Previous Studies on the Spinal Vascular System.- Experimental Methods and Clinical Examination Techniques.- 1. Anatomical Methods and Materials.- 2. Injection Techniques.- 3. Radiographic Techniques.- 3.1. Postmortem Macro- and Microangiography.- 3.2. Spinal Angiography in Animals.- 3.3. Clinical Spinal Angiography.- 3.4. Myelography.- 4. Own Investigations.- Anatomy of the Spinal Cord´s Blood Supply.- 1. Embryology.- 2. Sources of Arterial Blood Supply and Radicular Feeders.- 3. Extramedullar Venous Drainage.- Postmortem Angiography and Microangiography of Spinal Cord Vessels.- A. Arteries.- 1. Superficial Arterial System.- 1.1. Cervical Region.- 1.2. Thoracic Region.- 1.3. Thoracolumbar Region.- 2. Intrinsic Arterial System.- 2.1. Central System (Sulcal or Central Arteries).- 2.2. Peripheral System (Vasocorona).- 3. Arterial Territories of Supply.- 4. Arterio-arterial Anastomoses.- 5. Discussion of Arteriographical Findings-Physiological Aspects.- B. Veins.- 1. Superficial Venous System.- 2. Intrinsic Venous Systems.- 3. Transmedullary Venous Anastomoses.- 4. Discussion of Phlebographical Findings-Physiological Aspects.- C. Capillaries of the Spinal Cord.- D. Spinal Cord Arteries in Pathological Conditions.- Clinical Applications.- 1. Normal Anatomy in Selective Spinal Angiography.- 2. Spinal Vascular Malformations.- 2.1. Myelography.- 2.2. Angiographical Findings and Their Classification.- 2.3. Discussion.- 3. Vertebrospinal Space-occupying Lesions.- VII. Pathomorphological and Pathophysiological Aspects.- References.