Surgical Management of Angiographically Occult Spinal Dural Arteriovenous Fistulae (Type I Spinal Arteriovenous Malformations): Three Technical Case Reports

Surgical Management of Angiographically Occult Spinal Dural Arteriovenous Fistulae (Type I Spinal... ABSTRACTOBJECTIVE AND IMPORTANCE:Spinal dural arteriovenous fistulae (Type I spinal arteriovenous malformations [AVMs]) have been recognized as a treatable cause of progressive myelopathy. The diagnosis and characterization of these lesions rest heavily on spinal angiography.CLINICAL PRESENTATION:We present three patients whose clinical presentations were consistent with a spinal dural AVM but whose spinal angiographic results were negative.INTERVENTION:The surgical treatment of these angiographically occult spinal AVMs is described. In restrospect, in each case, the feeding vessel to the AVM was injected but not seen.CONCLUSION:Some spinal dural arteriovenous fistulae will be angiographically occult. If the clinical and radiographic presentations strongly suggest the presence of an arteriovenous fistula, surgical exploration should be considered. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Surgical Management of Angiographically Occult Spinal Dural Arteriovenous Fistulae (Type I Spinal Arteriovenous Malformations): Three Technical Case Reports

Surgical Management of Angiographically Occult Spinal Dural Arteriovenous Fistulae (Type I Spinal Arteriovenous Malformations): Three Technical Case Reports

C a r d i o p u l m o n a r y Bypass fo r A r t e r i o v e n o u s F is tu la R e s e c tio n 891 was justified. H o w e v e r , i n a d d i t i o n , t h i s t h e h i g h c a r d i a c o u t p u t t o t h e f i s t u l a . g e o u s , a n d s u c c e s s f u l a p p r o a c h t o t h i s p a t i e n t h a d a c a r d i a c o u t p u t o f 9 L a n d T h i s i s a v e r y r a r e s i t u a t i o n ; I r e m e m b e r p r o b l e m . th e a u t h o r s h a d e v e r y r e a s o n t o a t ­ o n l y t w o o r t h r e e a d u l t s w h o h a d s i g ­ R o b e r t o C . H e r o s t r i b u t e t h i s i n t o l e r a b l y h i g h c a r d i a c o u t ­ n i f i c a n t l y e l e v a t e d c a r d i a c o u t p u t s a s a M iam i, Florida p u t t o t h e f i s t u l a . T h i s a l o n e , i n m y r e s u l t o f a n i n t r a c r a n i a l p a r e n c h y m a l a r ­ o p i n i o n , m a n d a t e d t r e a t m e n t , e v e n a t e r i o v e n o u s f i s t u l a s . O f c o u r s e , I h a v e r i s k y t r e a t m e n t , s u c h a s t h e o n e u n d e r ­ n o t m e a s u r e d c a r d i a c o u t p u t r o u t i n e l y t a k e n b y t h e a u t h o r s u n d o u b t e d l y w a s . 1. H ero s R C : S u rg e ry for a rte rio ve n o u s m a lfo r­ i n a d u l t p a t i e n t s w i t h A V M s , a n d I m ations of the b ra in , in O jem ann R G , O g ilv y T h e r e t u r n o f t h e c a r d i a c o u t p u t t o n o r ­ t h e r e f o r e c a n n o t b e s u r e t h a t t h e s i t u a ­ CS, Crow ell RM , Heros RC (eds): Surgical Man­ m a l a f t e r e x c i s i o n o f t h e f i s t u l a p r o v e d t i o n i s n o t m o r e c o m m o n . T h e a u t h o r s agement o f Neurovascular Disease. Baltimore, W il­ t h a t t h e a u t h o r s w e r e r i g h t i n a t t r i b u t i n g p r o v i d e a t h o u g h t f u l , i n n o v a t i v e , c o u r a ­ liams & W ilkins, 1995, ed 3, pp 421^476. p l y a n d v e n o u s...
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Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199904000-00128
Publisher site
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Abstract

ABSTRACTOBJECTIVE AND IMPORTANCE:Spinal dural arteriovenous fistulae (Type I spinal arteriovenous malformations [AVMs]) have been recognized as a treatable cause of progressive myelopathy. The diagnosis and characterization of these lesions rest heavily on spinal angiography.CLINICAL PRESENTATION:We present three patients whose clinical presentations were consistent with a spinal dural AVM but whose spinal angiographic results were negative.INTERVENTION:The surgical treatment of these angiographically occult spinal AVMs is described. In restrospect, in each case, the feeding vessel to the AVM was injected but not seen.CONCLUSION:Some spinal dural arteriovenous fistulae will be angiographically occult. If the clinical and radiographic presentations strongly suggest the presence of an arteriovenous fistula, surgical exploration should be considered.

Journal

NeurosurgeryOxford University Press

Published: Apr 1, 1999

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