What is a cremaster vascular malformation? Crestal vascular malformation is a congenital abnormality or malformation in the development of the crestal vessels. It is more common in the thoracic segment and to a lesser extent in the lumbosacral segment. It may also involve the entire length of the crestal medulla. Sudden head and neck or lumbosacral pain, incomplete or complete paraplegia or quadriplegia may occur clinically. Paraplegia with a remission phase is its characteristic manifestation. The age of onset is more common in young and middle-aged people. If early diagnosis and radical surgery are obtained, many patients can have a good outcome. What are the common clinical manifestations? 1, pain: early often transient nerve root pain, intermittent or severe pain. It is stabbing or burning-like. The location coincides with the lesion segment. 2. Sensory symptoms: numbness and ankylosis in the limbs, often with deep and superficial somatic sensory disturbances. 3, motor symptoms: limb weakness, gradually increasing, complete or incomplete paralysis of one or both limbs. 4.Sphincter symptoms: urinary and fecal incontinence. 5.Spontaneous subarachnoid hemorrhage: sudden headache, paraplegia, cervical tonicity, and positive Creutzfeldt-Jakob sign. What are the bases of disease diagnosis? 1, slow onset, symptoms may be relieved during the course of the disease, partial or complete transverse damage signs appear below the plane of the lesion. 2.Lumbar puncture examination of the subarachnoid space has different degrees of obstruction. The cerebral crest fluid is yellowish or colorless and transparent, with increased protein content, sometimes containing red blood cells. MRI can sometimes show a mass or worm-like malformation with a flow-through effect. What are the current treatment means? 1.Surgical resection. 2.Vascular embolization: This method can be used for those who are difficult to be removed by surgery. 3.Radiotherapy: It may be effective for small malformed vessels. However, the overall efficacy is not good, so it is not recommended. At present, our neurological center uses the most advanced O-arm intraoperative localization system to determine the lesioned cremaster segment, combined with intraoperative fluorescence development technology, and precisely locates the lesioned trophoblastic artery, traffic branch and malformed vascular mass with the assistance of Zeiss 900 double fluorescence microscope, so as to completely remove the tumor while preserving the function of the cremaster to the maximum extent and creating the best opportunity for the long-term recovery of the patient. The department has successfully completed 4 cases of cristae At present, the department has successfully completed four cases of crestal vascular malformation surgery, all of which were successful, with complete resection of the malformed vessels and good postoperative recovery, and the patient has improved the function of the crestal medulla compared with that before surgery.