Double spinal dural arteriovenous fistulas.

Autor: Jablawi F; Department of Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstrasse, 30, 52074 Aachen, Germany; Department of Neurosurgery, Justus-Liebig-University, Klinikstrasse, 33, 35392 Giessen, Germany., Mull M; Department of Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstrasse, 30, 52074 Aachen, Germany. Electronic address: mmull@ukaachen.de.
Jazyk: angličtina
Zdroj: Journal of neuroradiology = Journal de neuroradiologie [J Neuroradiol] 2019 May; Vol. 46 (3), pp. 168-172. Date of Electronic Publication: 2018 Oct 30.
DOI: 10.1016/j.neurad.2018.09.004
Abstrakt: Background: Spinal dural arteriovenous fistulas (SDAVF) are usually solitary lesions. Synchronous and/or metachronous double SDAVF have rarely been reported in the literature. We report on three patients with double SDAVF and present our single center experience in the diagnostic and treatment management in these patients.
Material and Methods: We retrospectively revised our medical database for all patients who were diagnosed and treated in our center due to a SDAVF between 1990 and 2017. All data including demographics, clinical presentations, as well as radiological data were re-evaluated for this study.
Results: Three (1.4%) of 209 consecutive patients with SDAVF presented double SDAVF with different arterial feeders and venous drainage patterns. All three patients were men. The mean age at time of diagnosis was 67.9 ± 10 years (median; 68, range: 53-82). Myelopathic symptoms were reported in all three cases. All three fistulas were located in the thoracolumbar region between T7 and L2. MRI/CE-MRA showed medullar T2-hyperintensity, intramedullary contrast-enhancement and dilatation of perimedullary veins in various extensions.
Conclusion: Double SDAVF are extremely rare and were found in 1.4% of patients in our series. The vast majority of the reported double SDAVF in the literature has been detected synchronously within an area of equal or less than three vertebral levels. Thus, whenever the SDAVF is identified, further injections of the fistula-zone neighbored segmental arteries might be recommended. However, due to the extremely low incidence of double SDAVF a complete spinal DSA is not indicated.
(Copyright © 2018 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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