MRI findings of spinal arteriovenous fistulas: focusing on localisation of fistulas and differentiation between spinal dural and perimedullary arteriovenous fistulas

Yang, Hyun Kyoung; Lee, J.W.; Jo, Seong-Rae; Jung, Cheolkyu; Kwon, O-Ki; Lee, E.; Ahn, Joong Mo; Kang, Heung Sik

doi:10.1016/j.crad.2016.01.007

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…Our patient could tolerate epidural steroid injections prior to his initial laminectomy, suggesting that SDAVF may have formed as a complication of the surgery. Review of the initial lumbar laminectomy operative note did not reveal any report of abnormal vasculature, although this does not exclude its pre-existence Diagnosis of SDAVF is challenging as symptoms are non-specific, MRI findings are often subtle, and spondylopathy is often a comorbidity [6,7]. Paraparesis has been found to be the most common initial presenting symptom in patients with SDAVF but variability exists in the severity of this symptom [7].…”

Section: Etiology and Diagnosismentioning

confidence: 99%

Reversible Aggravation of Neurological Deficits after Transforaminal Epidural Steroid Injection in a Patient with Undiagnosed Spinal Dural Arteriovenous Fistula

Go¹,

Lantos²,

Ngeow³

2020

J Clin Stud Rev Rep

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Here we present a case of a 77-year-old man who underwent an epidural steroid injection complicated by delayed monoplegia and urinary incontinence. An MRI showed T2 hyperintensity at the conus along with small serpentine vessels surrounding the spinal cord. An angiogram was performed which showed a spinal dural arteriovenous fistula (SDAVF) with prominent draining vein at the right L3 level. The patient underwent repeat laminectomy and disconnection of spinal dural fistula after failed endovascular repair. His symptoms slowly improved after the lumbar decompression and physical therapy. SDAVF remains a diagnostic challenge. Epidural injection is contraindicated in these patients due to venous hypertension resulting in possible conus ischemia. SDAVF must be considered in the differential diagnosis when unexpected neurological complications occur after epidural steroid injection.

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Section: Etiology and Diagnosismentioning

confidence: 99%

Reversible Aggravation of Neurological Deficits after Transforaminal Epidural Steroid Injection in a Patient with Undiagnosed Spinal Dural Arteriovenous Fistula

Go¹,

Lantos²,

Ngeow³

2020

J Clin Stud Rev Rep

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show abstract

“…PMAVFs typically demonstrate an enhanced dilated perimedullary vein or an ectatic venous pouch in combination with an enlarged spinal artery and no AVM nidus (46). For macro-PMAVFs, the venous ectasia may be so large that it compresses the cord and contributes to cord dysfunction, as indicated by a focal hyperintensity on T2-WI compared to the venous ectasia.…”

Section: Magnetic Resonance Angiography (Mra) and Magnetic Resonance mentioning

confidence: 99%

Study and therapeutic progress on spinal cord perimedullary arteriovenous fistulas

Guo

Shi

et al. 2017

Biomedical Reports

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Abstract. Spinal cord perimedullary arteriovenous fistulas (PMAVFs) are rare and belong to type IV spinal cord arteriovenous malformations (AVMs). Little is known regarding the treatment and prognosis of spinal cord PMAVFs. In the present study the relevant literature from PubMed was reviewed, and it was found that these fistulas can occur at all ages but are more common in children. In children, most spinal cord PMAVFs are large and with high flow, begin with bleeding and are frequently associated with hereditary hemorrhagic telangiectasia. However, in adults, most spinal cord PMAVFs are small and with low flow and begin with progressive spinal cord dysfunction. The early diagnosis of spinal cord PMAVFs is generally difficult, and symptoms can be very severe at the time of diagnosis. Digital subtraction angiography remains the gold standard; however, computed tomography angiography and magnetic resonance angiography are also promising. Spinal cord PMAVFs can be treated by endovascular embolization, surgical removal or a combination of the two methods. Most spinal cord PMAVFs show good outcomes after the appropriate treatment, and the prognosis is primarily associated with the blood flow of the PMAVF. For high-flow spinal cord PMAVFs, endovascular embolization is more effective and can lead to a good outcome; however, for low-flow spinal cord PMAVFs, surgical removal or the combination with endovascular embolization is the optimal choice. The prognosis for low-flow types is slightly worse than for high-flow spinal cord PMAVFs in children, but the outcome is acceptable.

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Spinal Vascular Malformations

Spears

Fraser

2022

Introduction to Vascular Neurosurgery

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MRI findings of spinal arteriovenous fistulas: focusing on localisation of fistulas and differentiation between spinal dural and perimedullary arteriovenous fistulas

Cited by 6 publications

References 21 publications

Reversible Aggravation of Neurological Deficits after Transforaminal Epidural Steroid Injection in a Patient with Undiagnosed Spinal Dural Arteriovenous Fistula

Reversible Aggravation of Neurological Deficits after Transforaminal Epidural Steroid Injection in a Patient with Undiagnosed Spinal Dural Arteriovenous Fistula

Study and therapeutic progress on spinal cord perimedullary arteriovenous fistulas

Spinal Vascular Malformations

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