The external carotid artery as a rare feeder of a spinal dural arteriovenous fistula causing cervical myelopathy: A review of the literature

Broekx, Senne; Houben, Rik; Stockx, L; Boulanger, T.; Gelin, G; Weyns, F.; Beule, Tom De

doi:10.1016/j.bas.2021.100299

Cited by 1 publication

(1 citation statement)

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“…In the thoracic and lumbar regions, intercostal and lumbar arteries serve as segmental arteries that supply spinal arteries. About 1-2% of cervical SDAVFs are located at the craniocervical junction, of which 12% are caused by arterial feeders from the external carotid artery [29]. A correct diagnosis can be challenging, and a high rate of initial misdiagnosis is possible.…”

Section: Neuroimaging Findingsmentioning

confidence: 99%

Delayed Diagnosis of Spinal Dural Arteriovenous Fistula: A Case Report and Scoping Review

Tanaka,

Yamane,

Sashida

et al. 2024

JCM

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Spinal dural arteriovenous fistula (SDAVF) is among the most common arterial shunt diseases typically found in middle aged or older men. Herein, we aimed to clarify the reasons for misdiagnoses and delayed diagnoses of SDAVF, determine how these affect prognoses, and establish how they can be prevented. We conducted a PubMed/MEDLINE literature search using “spinal dural arteriovenous fistula”, “delayed diagnosis”, “late diagnosis”, and “misdiagnosis” terms. We identified 18 articles, including 965 SDAVF cases. Patients were predominantly males (71.8–100.0%) (mean age: 53.5–71.0 years). Misdiagnoses rates varied (17.5–100.0%) and encompassed many conditions. The mean time between early manifestations and confirmed diagnosis was approximately 10–15 months and from the first radiologic image revealing dural arteriovenous fistula (DAVF) features to diagnosis was 9.2–20.7 months. Posttreatment outcomes showed a significant improvement in motor functions, gait, and micturition, particularly in patients exhibiting preoperative symptoms over a short period. SDAVF is frequently misdiagnosed or subject to delayed diagnosis, causing poor clinical outcomes. SDAVF symptoms including progressive lower-limb weakness, paresthesia, and vesicorectal dysfunction are indications for spinal magnetic resonance imaging with subsequent spinal angiography, wherein DAVF is evidenced by extensive T2 hyperintensity and flow-void abnormalities. We reported a representative case with delayed diagnosis.

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Section: Neuroimaging Findingsmentioning

confidence: 99%