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Perimedullary arteriovenous fistula of the filum terminale: case report.
Neurosurgery. 2010 Jan; 66(1):E219-20; discussion E220.N

Abstract

OBJECTIVE

Although a dural or intramedullary arteriovenous fistula involving the conus medullaris and fed by the lateral sacral artery has been reported, a case of perimedullary fistula arising from an artery in the filum terminale has not been described in the literature. The authors report the first case of perimedullary arteriovenous fistula located in the filum terminale.

CLINICAL PRESENTATION

A 61-year-old man presented with a 10-year history of leg pain. Thoracolumbar magnetic resonance imaging scans revealed multiple perimedullary signal voids from T10 to L3. Angiography showed engorged perimedullary veins and a fistula fed by the anterior spinal artery from the right ninth segmental artery and by 2 branches of the left lateral sacral artery. The anterior spinal artery was also regarded as the artery of the filum terminale.

INTERVENTION

Transarterial embolization was performed to occlude the feeders from the left lateral sacral artery, and an L5 total laminectomy was subsequently performed to obliterate residual fistulous material from the artery of the filum terminale. The thickened, yellowish filum, surrounded by tortuous, engorged veins, was coagulated and resected. Postoperatively, the patient's symptoms gradually resolved and were not aggravated during long periods of walking.

CONCLUSION

It must be noted that a fistula can be located in the filum terminale and can be successfully treated using multidisciplinary approaches.

Authors+Show Affiliations

Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20023527

Citation

Jin, Yong Jun, et al. "Perimedullary Arteriovenous Fistula of the Filum Terminale: Case Report." Neurosurgery, vol. 66, no. 1, 2010, pp. E219-20; discussion E220.
Jin YJ, Kim KJ, Kwon OK, et al. Perimedullary arteriovenous fistula of the filum terminale: case report. Neurosurgery. 2010;66(1):E219-20; discussion E220.
Jin, Y. J., Kim, K. J., Kwon, O. K., & Chung, S. K. (2010). Perimedullary arteriovenous fistula of the filum terminale: case report. Neurosurgery, 66(1), E219-20; discussion E220. https://doi.org/10.1227/01.NEU.0000359529.40577.A1
Jin YJ, et al. Perimedullary Arteriovenous Fistula of the Filum Terminale: Case Report. Neurosurgery. 2010;66(1):E219-20; discussion E220. PubMed PMID: 20023527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perimedullary arteriovenous fistula of the filum terminale: case report. AU - Jin,Yong Jun, AU - Kim,Ki-Jeong, AU - Kwon,O Ki, AU - Chung,Sang Ki, PY - 2009/12/22/entrez PY - 2009/12/22/pubmed PY - 2010/3/3/medline SP - E219-20; discussion E220 JF - Neurosurgery JO - Neurosurgery VL - 66 IS - 1 N2 - OBJECTIVE: Although a dural or intramedullary arteriovenous fistula involving the conus medullaris and fed by the lateral sacral artery has been reported, a case of perimedullary fistula arising from an artery in the filum terminale has not been described in the literature. The authors report the first case of perimedullary arteriovenous fistula located in the filum terminale. CLINICAL PRESENTATION: A 61-year-old man presented with a 10-year history of leg pain. Thoracolumbar magnetic resonance imaging scans revealed multiple perimedullary signal voids from T10 to L3. Angiography showed engorged perimedullary veins and a fistula fed by the anterior spinal artery from the right ninth segmental artery and by 2 branches of the left lateral sacral artery. The anterior spinal artery was also regarded as the artery of the filum terminale. INTERVENTION: Transarterial embolization was performed to occlude the feeders from the left lateral sacral artery, and an L5 total laminectomy was subsequently performed to obliterate residual fistulous material from the artery of the filum terminale. The thickened, yellowish filum, surrounded by tortuous, engorged veins, was coagulated and resected. Postoperatively, the patient's symptoms gradually resolved and were not aggravated during long periods of walking. CONCLUSION: It must be noted that a fistula can be located in the filum terminale and can be successfully treated using multidisciplinary approaches. SN - 1524-4040 UR - https://www.unboundmedicine.com/medline/citation/20023527/Perimedullary_arteriovenous_fistula_of_the_filum_terminale:_case_report_ L2 - https://academic.oup.com/neurosurgery/article-lookup/doi/10.1227/01.NEU.0000359529.40577.A1 DB - PRIME DP - Unbound Medicine ER -