Spinal Dural Arteriovenous Fistulae Draining to the Anterior Spinal Vein: Angiographic Diagnosis

Spinal Dural Arteriovenous Fistulae Draining to the Anterior Spinal Vein: Angiographic Diagnosis AbstractOBJECTIVETo 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.METHODSA 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.RESULTSThe appearance of the venous drainage mimicked that of the usual hairpin configuration of the radicu- lomedullary 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.CONCLUSIONBefore performing endovascular treatment, thorough spinal angiography with an appropriate field of view must be performed to identify this unusual type of SDAVF. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Spinal Dural Arteriovenous Fistulae Draining to the Anterior Spinal Vein: Angiographic Diagnosis

Spinal Dural Arteriovenous Fistulae Draining to the Anterior Spinal Vein: Angiographic Diagnosis

Spinal Dural Arteriovenous Fistulae Draining to the Anterior Spinal Vein: Angiographic Diagnosis Yasunari Niimi, M .D., Avi Setton, M .D ., Alex Berenstein, M.D. In s t itu te fo r N e u r o l o g y a n d N e u r o s u r g e r y , C e n t e r fo r E n d o v a s c u l a r S u r g e r y , B e t h Is r a e l M e d i c a l C e n t e r N o r t h D iv i s io n , N e w Y o r k , N e w Y o r k 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 S D A V F s 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 radicu- lomedullary artery and therefore caused diagnostic difficulty. There are no characteristic clinical features that differentiate this form of S D A V F from the usual type of SD A VF. The angiographic criteria for identification of the ASV draining an S D A V F include the demonstration of the branching of the ASV and its drainage into the epidural vein, opacification of other m edullary 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 em bolization 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...
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Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199905000-00036
Publisher site
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Abstract

AbstractOBJECTIVETo 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.METHODSA 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.RESULTSThe appearance of the venous drainage mimicked that of the usual hairpin configuration of the radicu- lomedullary 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.CONCLUSIONBefore performing endovascular treatment, thorough spinal angiography with an appropriate field of view must be performed to identify this unusual type of SDAVF.

Journal

NeurosurgeryOxford University Press

Published: May 1, 1999

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