Guest Post from
Michael P. Steinmetz, MD
Chairman, Department of Neurosurgery
Case Western Reserve University School of Medicine
MetroHealth Medical Center
Cleveland, OH
“Common things are common,” is an often-used phrase in medicine. At times, however, this edict does not ring true as highlighted in an article in the Miami Times. The piece recounts how Connie Daniels developed progressive neurological symptoms. They became so severe she was admitted to a local hospital. However, despite multiple tests, a diagnosis could not be made. Then, neurosurgical expertise at the Jackson Health System was able to unearth the cause. Her neurosurgeon, Mohamed Samy Elhammady, M.D., diagnosed her with a spinal arteriovenous malformation (AVM).
Spinal AVMs are rare conditions that often go undiagnosed for months to years. Patients typically present with symptoms very similar to more common ailments such as degenerative spine problems or multiple sclerosis. While receiving treatment for these conditions, the patient continues to deteriorate. As illustrated in the case of Connie Daniels, it often falls to a neurosurgeon to make the diagnosis as they are experts in diseases of the nervous system including vascular anomalies.
Once the diagnosis is made, rapid treatment is often indicated. In many cases, once the vascular abnormality (fistula) is obliterated, the patient’s symptoms stabilize or improve. This may occur rapidly as illustrated in the article. Thus, this neurosurgical treatment is life altering. While the options for treatments may involve either traditional “open” surgery or surgery done through specialized intravascular surgery, neurosurgical expertise is crucial to successful outcomes.
Whether a patient has a rare problem like a spinal vascular malformation such as that of Connie Daniels or the more common degenerative, traumatic and tumor diseases of the spine, neurosurgeons are spine experts who are committed to providing the best care for our patients.