Vascular malformations masquerading as demyelinating disease. May be the explanation?

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frodo
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Vascular malformations masquerading as demyelinating disease. May be the explanation?

Post by frodo » Tue Oct 08, 2019 2:45 am

This report shows that blood flow problems can produce demyelinating lesions similar to those seen in MS. Anyway, the authors state that this kind of demyelination should be not considered MS, but just a separated demyelinating disease.

Vascular malformations masquerading as demyelinating disease

https://www.sciencedirect.com/science/a ... via%3Dihub

Highlights

•AVMs/dAVFs can mimic demyelinating disease like NMO, ADEM, or transverse myelitis.
•Symptoms of vascular malformation can be worsened if treated with steroids.
•In atypical demyelinating disease, our cases back angiography to preclude AVMs/dAVFs.

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ThisIsMA
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Re: Vascular malformations masquerading as demyelinating disease. May be the explanation?

Post by ThisIsMA » Tue Jun 16, 2020 10:27 am

Wow, I'd sure like to read that study, but its behind a paywall.

It does list the highlights of the study which include:
Highlights
• AVMs/dAVFs can mimic demyelinating disease like NMO, ADEM, or transverse myelitis.

Symptoms of vascular malformation can be worsened if treated with steroids.

• In atypical demyelinating disease, our cases back angiography to preclude AVMs/dAVFs.
Bold type added by me.

More research on this should be a top priority because if its true that vascular malformations can masquerade as demyelinating disease, and if steroids can make the symptoms of vascular malformations worse. Then with so many people with demyelinating diseases being treated with steroids for flair ups... It seems like some of those people, misdiagnosed who actually have vascular malformations, might be being harmed by the steroid treatments.

On the other hand maybe it could be diagnostic: If you are treated with steroids for a flair up and the flair up gets worse instead of better, maybe that could be a sign that what you have is actually vascular malformations? Just a guess...

Disclaimer: I'm NOT a medical professional, just a person with MS. Consult your own medical professionals before making decisions about your health.
DX 6-09 RRMS, now SPMS

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frodo
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Re: Vascular malformations masquerading as demyelinating disease. May be the explanation?

Post by frodo » Fri Jun 19, 2020 1:21 am

ThisIsMA wrote:
Tue Jun 16, 2020 10:27 am
Wow, I'd sure like to read that study, but its behind a paywall.
In my case I can read it without any warning. I suppose that it is possible to reproduce an excerpt acknowleging the authorship. It is a review of three cases in which patients with vascular problems present demyelination and were diagnosed each one with neuromyelitis optica, acute disseminated encephalomyelitis, and transverse myelitis.

Vascular malformations masquerading as demyelinating disease
Author:Gabriel Lupu,Jonathan F. Cahill,Syed A. Rizvi
Publication:Multiple Sclerosis and Related Disorders
Publisher:Elsevier
Date:February 2020

Case #1: .... Brain MRI revealed abnormal signal intensity in the medulla with patchy contrast-enhancement and diffuse swelling. She was diagnosed with a subacute brainstem infarction

Case #2: ... Upon return presentation, brain MRI demonstrated two ovoid, enhancing lesions in the brainstem. C-spine MRI demonstrated three abnormal T2 lesions. Two lesions were in the brainstem: there was a 6 mm focus of high T2 signal within the left paramedian pons and the previously visualized high T2 signal in the left half of the medulla. Both of these lesions enhanced with gadolinium, and there was also slight expansion of the medulla. ... with no inflammatory cells or oligoclonal bands. CSF studies were also negative for lyme, cryptococcal antigens, cytomegalovirus PCR, and angiotensin converting enzyme. The patient's clinical examination deteriorated on steroids...

Case #3: MRI showed abnormal increased T2 signal intensity and swelling... The diagnosis was incomplete transverse myelitis ... a second angiogram was performed of the left internal iliac artery, which demonstrated multiple feeders to a dural AV fistula at S1.

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