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[Conus perimedullary arteriovenous fistula with multiple shunt points including the cauda equina: a case report].
No Shinkei Geka. 2011 Apr; 39(4):375-80.NS

Abstract

Perimedullary arteriovenous fistula (AVF) is usually located on the surface of the spinal cord and is fed by the anterior spinal artery and/or the posterior spinal artery. We report a rare case of Conus perimedullary AVF with multiple shunt points including the cauda equina. A 68-year-old man presented with leg pain when walking long distances. Magnetic resonance imaging at the thoracic and lumbar level revealed multiple signal voids with marked cord signal change. Angiography showed the perimedullary AVF fed by the anterior spinal artery from the right T9 intercostal artery at the level of the conus medullaris and the fistula fed by the left lateral sacral artery from the left internal iliac artery at the level of the cauda equina. In the first surgery, we performed surgical interruption of feeding arteries from the filum terminale and coagulated AV shunt of the conus medullaris. However residual perimedullary AVF was found at the conus medullaris in the postoperative angiography. Secondary surgery was carried out to treat residual AVF. Follow-up angiography showed complete disappearance of all AVFs. Postoperatively, the patient`s symptoms were improved. Because the Conus perimedullary AVF has the characteristics of multiple feeding arteies, multiple shunt points, and complex venous drainage, it must be kept in mind that other fistula could exist in the cauda equina or filum terminale.

Authors+Show Affiliations

Department of Neurosurgery, Hokkaido University Graduate School of Medicine.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article
Review

Language

jpn

PubMed ID

21447852

Citation

Saito, Hisayasu, et al. "[Conus Perimedullary Arteriovenous Fistula With Multiple Shunt Points Including the Cauda Equina: a Case Report]." No Shinkei Geka. Neurological Surgery, vol. 39, no. 4, 2011, pp. 375-80.
Saito H, Hida K, Asano T, et al. [Conus perimedullary arteriovenous fistula with multiple shunt points including the cauda equina: a case report]. No Shinkei Geka. 2011;39(4):375-80.
Saito, H., Hida, K., Asano, T., Yano, S., Aoyama, T., Iwasaki, Y., & Houkin, K. (2011). [Conus perimedullary arteriovenous fistula with multiple shunt points including the cauda equina: a case report]. No Shinkei Geka. Neurological Surgery, 39(4), 375-80.
Saito H, et al. [Conus Perimedullary Arteriovenous Fistula With Multiple Shunt Points Including the Cauda Equina: a Case Report]. No Shinkei Geka. 2011;39(4):375-80. PubMed PMID: 21447852.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Conus perimedullary arteriovenous fistula with multiple shunt points including the cauda equina: a case report]. AU - Saito,Hisayasu, AU - Hida,Kazutoshi, AU - Asano,Takeshi, AU - Yano,Shunsuke, AU - Aoyama,Takeshi, AU - Iwasaki,Yoshinobu, AU - Houkin,Kiyohiro, PY - 2011/3/31/entrez PY - 2011/3/31/pubmed PY - 2011/5/27/medline SP - 375 EP - 80 JF - No shinkei geka. Neurological surgery JO - No Shinkei Geka VL - 39 IS - 4 N2 - Perimedullary arteriovenous fistula (AVF) is usually located on the surface of the spinal cord and is fed by the anterior spinal artery and/or the posterior spinal artery. We report a rare case of Conus perimedullary AVF with multiple shunt points including the cauda equina. A 68-year-old man presented with leg pain when walking long distances. Magnetic resonance imaging at the thoracic and lumbar level revealed multiple signal voids with marked cord signal change. Angiography showed the perimedullary AVF fed by the anterior spinal artery from the right T9 intercostal artery at the level of the conus medullaris and the fistula fed by the left lateral sacral artery from the left internal iliac artery at the level of the cauda equina. In the first surgery, we performed surgical interruption of feeding arteries from the filum terminale and coagulated AV shunt of the conus medullaris. However residual perimedullary AVF was found at the conus medullaris in the postoperative angiography. Secondary surgery was carried out to treat residual AVF. Follow-up angiography showed complete disappearance of all AVFs. Postoperatively, the patient`s symptoms were improved. Because the Conus perimedullary AVF has the characteristics of multiple feeding arteies, multiple shunt points, and complex venous drainage, it must be kept in mind that other fistula could exist in the cauda equina or filum terminale. SN - 0301-2603 UR - https://www.unboundmedicine.com/medline/citation/21447852/[Conus_perimedullary_arteriovenous_fistula_with_multiple_shunt_points_including_the_cauda_equina:_a_case_report]_ L2 - https://webview.isho.jp/openurl?rft.genre=article&rft.issn=0301-2603&rft.volume=39&rft.issue=4&rft.spage=375 DB - PRIME DP - Unbound Medicine ER -