Spinal Dural Arteriovenous Fistulas: Clinical Results and Quality of Life Assessment with Surgical Treatment as a Crucial Therapy. The Joint Experience of Two Centers

Fiaschi, Pietro; Prior, Alessandro; Sbaffi, Pier Filippo; Bizzi, Fabiola; D’Andrea, Alessandro; Cagetti, Bernarda; Badaloni, Filippo; Allegretti, L.; Mavilio, N.; Padolecchia, Riccardo; Valsania, Valtero; Zona, Gianluigi

doi:10.1016/j.wneu.2018.10.019

Cited by 11 publications

(6 citation statements)

References 16 publications

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“…The previous studies have reported that ALS for gait, urination, and defecation recovered approximately 1 point each at post-operative 1 year (8,29). In the case of the most severe disability in each item, it was very rare that the patient recovered close to normal (30). However, just as in our case, reversal of myelopathy is possible with prompt treatment before irreversible neurological damage is done (31).…”

Section: Discussionsupporting

confidence: 51%

Rapid Progression to Complete Paraplegia After Electroacupuncture in a Patient With Spinal Dural Arteriovenous Fistula: A Case Report

et al. 2021

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Spinal dural arteriovenous fistula (SDAVF) usually has an insidious clinical course, but 5–15% of the cases have acute exacerbations. In some cases, there is an abrupt progression to paraplegia following an epidural injection or anesthesia. Electroacupuncture is a form of acupuncture that applies a small electrical current to needles inserted at specific points in the body. It is widely used for its analgesic effect on back pain. In this study, we report a rare case of SDAVF in which the symptoms of a patient worsened rapidly to complete paraplegia within a few hours after applying electroacupuncture to his back. A 49-year-old man had rapid progression to complete paraplegia within a few hours of electroacupuncture on his back. MRI showed SDAVF and worsening of cord signal change. An emergency operation was performed to ligate the SDAVF. The patient was able to walk 1 month post-operatively. Most of the neurological deficits had disappeared by 1 year post-operatively, with normalization of MRI. Our case emphasizes that SDAVF patients should be careful when exposed to any circumstances that might affect the circulation around the dural arteriovenous fistula, such as electroacupuncture. Patients should also be warned in advance about the possibility of rapid exacerbation of neurological symptoms. Regardless of the severity of the neurological symptoms, immediate treatment is essential for recovery and a better outcome.

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Section: Discussionsupporting

confidence: 51%

Rapid Progression to Complete Paraplegia After Electroacupuncture in a Patient With Spinal Dural Arteriovenous Fistula: A Case Report

et al. 2021

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“…In support to this theory, Malek et al [11] reported that spinal aneurysms are more frequently associated with AVMs compared to dural arteriovenous fistulas(DAVF) [12]. The authors explained this finding with the high flow nature of AVMs compared to DAVF that are characterized by a lower flow.…”

Section: Discussionmentioning

confidence: 97%

“…According to the PRISMA protocol for systematic reviews and meta-analysis 12 , we have systematically reviewed the published literature regarding SA associated with intramedullary or conus medullaris AVMs. The literature search was performed on PubMed/MEDLINE (US National Library of Medicine).…”

Section: Methodsmentioning

confidence: 99%

Management of spinal aneurysms associated with arteriovenous malformations: systematic literature review and illustrative case

et al. 2021

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Purpose Spinal aneurysms are rare vascular malformations, commonly associated with spinal AVMs. AVM-associated spinal aneurysms are burdened by significant morbidity. The purpose of our study is to evaluate the best treatment strategy for these uncommon vascular lesions and to report an illustrative case. Methods We reviewed clinical and radiological data of a patient surgically treated at our institution for a spinal AVM with an associated prenidal aneurysm. According to PRISMA guidelines, a systematic literature review has been performed in order to discuss the best management AVM-associated prenidal aneurysms. Results In the reported case, the aneurysm showed spontaneous regression at follow-up after surgical removal of the AVM. Only 6 articles reported management of spinal prenidal AVM-associated aneurysms. Basing on our experience and data from literature, surgical treatment of the aneurysm may be indicated along with the resection of the AVM if the aneurysm is close to the nidus. Conversely, if the aneurysm is far away from the nidus or in an unfavorable position, resection of the nidus only may lead to aneurysm regression as in the reported case. Conclusions The treatment strategy for AVM-associated spinal aneurysms should be tailored on the single patient. In presence of large aneurysms that cause mass-effect symptoms, when rupture of the aneurysm is suspected or when treatment of the AVM is not proposable, direct treatment of the aneurysm should be considered. Otherwise, when complete resection of the nidus is performed, the eventually associated unruptured aneurysms located in challenging positions can be safely managed conservatively.

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“…In 2021, Fiaschi and colleagues found improvement of motor symptoms in >80% of patients following surgical obliteration and improvement of sphincter dysfunction in >30%. Additionally, their cohort demonstrated higher patient quality-of-life perceptions following surgical management when compared to embolization [164].…”

Section: Surgical Management Of Davfmentioning

confidence: 95%

Update on Management of Dural Arteriovenous Fistulas

Azab

Dioso

Findlay³

et al. 2022

jrdod

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Dural Arteriovenous Fistulas (AVF) represent about 10% of all intracranial vascular lesions. Although they seem benign in nature, the presence of retrograde venous makes them aggressive, with a high risk of complications. Patients may be clinically asymptomatic or experience symptoms ranging from mild to severe hemorrhage, depending on their location. Different treatments are available, but recently, the development of catheter intervention allows most patients to be cured with transcatheter embolization. Stereotactic radiosurgery achieves excellent rates of obliteration for low-grade lesions. In this review, we try to highlight the recent advances in the management of dural AVF.

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Spinal Dural Arteriovenous Fistulas: Clinical Results and Quality of Life Assessment with Surgical Treatment as a Crucial Therapy. The Joint Experience of Two Centers

Cited by 11 publications

References 16 publications

Rapid Progression to Complete Paraplegia After Electroacupuncture in a Patient With Spinal Dural Arteriovenous Fistula: A Case Report

Rapid Progression to Complete Paraplegia After Electroacupuncture in a Patient With Spinal Dural Arteriovenous Fistula: A Case Report

Management of spinal aneurysms associated with arteriovenous malformations: systematic literature review and illustrative case

Update on Management of Dural Arteriovenous Fistulas

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