1/154. Dural arteriovenous fistula of the cervical spine presenting with subarachnoid hemorrhage.We describe a case of dural arteriovenous fistula (DAVF) presenting with subarachnoid hemorrhage (SAH). The diagnosis of DAVF was based on spinal angiography. A review of the literature revealed that five of 13 previously reported DAVFs of the cervical spine were accompanied by SAH. SAH has not been observed in DAVFs involving other segments of the spinal canal.- - - - - - - - - - ranking = 1keywords = spinal, spinal canal, canal (Clic here for more details about this article) |
2/154. Results of the surgical treatment of perimedullary arteriovenous fistulas with special reference to embolization.OBJECT: This retrospective study was performed to evaluate the results of surgical treatment and the use of preoperative embolization in managing patients with perimedullary arteriovenous fistulas (AVFs). methods: The authors studied 20 consecutive patients with perimedullary AVFs who underwent surgical treatment. Arteriovenous shunts were at the level of the cervical spine in five patients, the thoracic spine in 12, and the conus medullaris in three patients. Of the 20 AVFs, three were fed by the anterior spinal artery only, three by the posterior spinal artery, and 14 by both the anterior and posterior spinal arteries. Nine patients had varices that compressed the spinal cord. Eleven patients underwent surgery, and nine patients underwent surgery combined with adjuvant preoperative embolization. Preoperative embolization remarkably reduced blood flow through the AVFs and facilitated subsequent surgical procedures. Postoperative angiography revealed complete disappearance of the AVFs in 16 patients. However, small fistulas persisted in the other four patients, whose large lesions were fed by the anterior spinal artery. Postoperatively, neurological status was improved in 11 patients, unchanged in eight, and worse in one patient. CONCLUSIONS: Effective interruption of a spinal arteriovenous shunt was achieved by surgery in all cases, even when the anterior spinal artery was involved. For large and high-flow AVFs, embolization proved to be a useful adjunct to surgery.- - - - - - - - - - ranking = 3.1417479376788keywords = spinal (Clic here for more details about this article) |
3/154. Spinal dural arteriovenous fistula with an associated feeding artery aneurysm: case report.OBJECTIVE AND IMPORTANCE: A case of a spinal dural arteriovenous fistula (DAVF) with two associated feeding artery aneurysms is reported. Intradural spinal arteriovenous malformations have been associated with aneurysms that present with subarachnoid hemorrhage and with venous varices that produce mass effect, but spinal DAVFs have not previously been described in association with feeding artery aneurysms. CLINICAL PRESENTATION: A 71-year-old man presented with progressive spastic paraparesis, constipation, and overflow incontinence. magnetic resonance imaging demonstrated a spinal vascular lesion and venous ischemia in the lower spinal cord. Diagnostic spinal angiography revealed a DAVF originating from the left T11 radicular artery and having the unusual feature of two proximal feeding artery aneurysms. INTERVENTION: The patient deteriorated neurologically after undergoing angiography, prompting emergent surgery. The DAVF was resected through a T11 transpedicular approach. One aneurysm was dolichoectatic and therefore unclippable, requiring proximal occlusion of the parent artery after establishing tolerance of test occlusion using somatosensory evoked potentials; the second aneurysm was adjacent to the fistula and was resected with the DAVF. CONCLUSION: Feeding artery aneurysms in association with spinal DAVFs have not been previously reported. They present additional risk to patients and, with simple modifications of the standard operative approaches, can easily be treated as part of the surgery for the DAVF.- - - - - - - - - - ranking = 3.1417479376788keywords = spinal (Clic here for more details about this article) |
4/154. Spinal dural arteriovenous fistulae draining to the anterior spinal vein: angiographic diagnosis.OBJECTIVE: To describe and present atypical spinal dural arteriovenous fistulae (SDAVFs) that drain into the anterior spinal vein (ASV) and thus cause some degree of difficulty in differentiating the anterior spinal artery from the ASV. methods: A retrospective review of 80 selective spinal angiography procedures (with or without endovascular treatment) performed on SDAVFs since 1980 identified three cases in which the venous drainage was into a dilated ASV via a radicular vein. The patients included two men and one woman, ranging in age from 55 to 82 years (mean age, 71 yr), all of whom presented with mild to severe progressive paraparesis and sensory disturbance. RESULTS: The appearance of the venous drainage mimicked that of the usual hairpin configuration of the radiculomedullary artery and therefore caused diagnostic difficulty. There are no characteristic clinical features that differentiate this form of SDAVF from the usual type of SDAVF. The angiographic criteria for identification of the ASV draining an SDAVF include the demonstration of the branching of the ASV and its drainage into the epidural vein, opacification of other medullary veins connected with the ASV, recognition of distortion of the hairpin shape, and the identification of the anterior spinal artery at the segment where the ASV is opacified. Two patients were treated with embolization and one with surgery. All patients improved after the treatment. CONCLUSION: Before performing endovascular treatment, thorough spinal angiography with an appropriate field of view must be performed to identify this unusual type of SDAVF.- - - - - - - - - - ranking = 4.4882113395411keywords = spinal (Clic here for more details about this article) |
5/154. Intracranial dural fistula as a cause of diffuse MR enhancement of the cervical spinal cord.Spinal MR findings are reported in a patient with progressive myelopathy and intracranial dural arteriovenous fistula draining into spinal veins. Associated with previously reported abnormalities on T1 weighted and T2 weighted images, postcontrast T1 weighted images disclosed diffuse intense enhancement of the cervical cord itself. This enhancement decreased after endovascular treatment.- - - - - - - - - - ranking = 2.2441056697706keywords = spinal (Clic here for more details about this article) |
6/154. Extraspinal dural arteriovenous fistula in a patient with lipomyelodysplasia: value of MRI and MRA.Spinal dural arteriovenous fistulae are extremely rare in spinal dysraphism. A fistulous malformation within a lipomyelomeningocele has not been reported previously. A 50-year-old man presented with progressive paraparesis and bladder dysfunction. MRI revealed a large lumbar lipomyelomeningocele. A vascular malformation was indicated by abnormal signal in the thoracolumbar spinal cord and dilated perimedullary veins. Phase-contrast MRA demonstrated only the slow-flow veins of the fistula and an intradural ascending vein. Contrast-enhanced ultra-fast MRA gave excellent delineation of all parts of the fistula within the dysraphic lesion.- - - - - - - - - - ranking = 2.6929268037247keywords = spinal (Clic here for more details about this article) |
7/154. Progressive myelopathy caused by dural arteriovenous fistula at the craniocervical junction--case report.A 68-year-old male presented an unusual dural arteriovenous fistula (AVF) located at the craniocervical junction. magnetic resonance imaging revealed dilated perimedullary veins around the spinal cord at C-1 and C-2 levels, as well as high intensity signals in the spinal cord on T2-weighted images. Vertebral angiography identified an AVF at the point where the right vertebral artery penetrates the dura. The fistula was a single and direct communication between the vertebral artery and the spinal vein. Surgical interruption of the fistula at its venous side resulted in prompt improvement of both motor and sensory signs and symptoms.- - - - - - - - - - ranking = 1.3464634018623keywords = spinal (Clic here for more details about this article) |
8/154. A case of intracranial dural arteriovenous fistula draining into the spinal medullary veins.Intracranial dural arteriovenous fistulas draining into the spinal medullary veins (ICDAVFMs) are exceedingly rare lesions. Their diagnosis is difficult and is often made late. About twenty well documented cases have been published. We report a case in a 55-year-old woman who presented with persistent interscapular pain and neurological evidence of ascending myelopathy after therapy for cervicobrachial neuralgia. ICDAVFM should be considered by rheumatologists in patients with clinical and radiological findings suggestive of spinal cord disease, particularly if these findings indicate involvement of the medulla oblongata or cervical spinal cord.- - - - - - - - - - ranking = 3.1417479376788keywords = spinal (Clic here for more details about this article) |
9/154. Slender versus threatening angiodysplasias: observe, operate or obturate? A delusive decision.Beside the immediate success of surgery and of embolization of angiodysplasias, certain number of patients return to medical consultation, because recanalization of the arteriovenous fistulae after their resection or obturation. From the presentation of two clinical cases of thoracic angiodysplasia: one of them slender, and threatening the other, the authors point out the complications and recurrence after surgical resection or arterial embolization. The recurrence takes place even when only one artery remains permeable after resection or embolization of the fistula. There are cases where the affected limb has to be amputated. However, angiodysplasia shows itself in the stump of the amputee limb. Uncontrolled angio-genesis is the natural history or postoperatory evolution of angiodysplasias, probably originated by an erroneous genetic program, which persist in spite of resection of the vascular malformation, causing a therapeutic failure.- - - - - - - - - - ranking = 0.0027781393904226keywords = canal (Clic here for more details about this article) |
10/154. Three cases of dural arteriovenous fistula of the anterior condylar vein within the hypoglossal canal.Dural arteriovenous fistulas (DAVFs) of the anterior condylar vein are an uncommon but important subset of fistulas occurring at the skull base that can be confused with DAVFs of the marginal sinus on angiography. MR angiography source images can document the intraosseous extent and the relationship to the hypoglossal canal of this type of fistula, which can have significant clinical implications. We present the imaging features of angiography, CT, and MR angiography of three cases of DAVFs localized to the anterior condylar vein and within the hypoglossal canal, which were confirmed by source images from MR angiography. Transvenous coil embolization was curative in two of three cases and would seem to be the treatment of choice when venous access is available.- - - - - - - - - - ranking = 0.016668836342536keywords = canal (Clic here for more details about this article) |
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