Abstract
Spinal dural arteriovenous (AV) fistulas are the most commonly encountered vascular malformation of the spinal cord and a treatable cause for progressive para- or tetraplegia. They most commonly affect elderly men and are classically found in the thoracolumbar region. The AV shunt is located inside the dura mater close to the spinal nerve root where the arterial blood from a radiculomeningeal artery enters a radicular vein. The increase in spinal venous pressure leads to decreased drainage of normal spinal veins, venous congestion, and the clinical findings of progressive myelopathy. On MR imaging, the combination of cord edema, perimedullary dilated vessels, and cord enhancement is characteristic. Therapy has to be aimed at occluding the shunting zone, either by superselective embolization with a liquid embolic agent or by a neurosurgical approach. Following occlusion of the fistula, the progression of the disease can be stopped and improvement of symptoms is typically observed.
Highlights
Spinal Dural Arteriovenous FistulasSUMMARY: Spinal dural arteriovenous (AV) fistulas are the most commonly encountered vascular malformation of the spinal cord and a treatable cause for progressive para- or tetraplegia
Patients younger than 30 years of age constituted less than 1% of patients with a DAVF, whereas, to our knowledge, no patient younger than 20 years of age has ever been reported
It is presumed that spinal dural arteriovenous fistulas (SDAVFs) are acquired diseases, though their exact etiology is not known
Summary
SUMMARY: Spinal dural arteriovenous (AV) fistulas are the most commonly encountered vascular malformation of the spinal cord and a treatable cause for progressive para- or tetraplegia. The dorsal epidural group of AV shunts is related to veins that normally drain the spinous process and lamina at the spinal level They are related to the major dural venous sinuses (superior sagittal sinus and torcular and transverse sinuses) at the cranial level, the corresponding veins at the spinal level are poorly developed[4] and consist of a pair of longitudinal channels (ie, the posterior internal venous plexus). Low cervical DAVFs (below C2 and above T1) are extremely rare.[30,31] In approximately 2% of patients, double spinal DAVFs or an association of a spinal dural with a spinal pial AV shunt may be present, raising the possibility of a potential etiologic connection.[32,33]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
