Tags

Type your tag names separated by a space and hit enter

Microvascular anatomy of spinal dural arteriovenous fistulas: arteriovenous connections and their relationships with the dura mater.
J Neurosurg Spine. 2015 Oct; 23(4):526-33.JN

Abstract

OBJECT The microvascular anatomy of spinal dural arteriovenous fistulas (AVFs), especially the relationships of the vessels with the dura mater, has yet to be angiographically demonstrated in detail and proven histologically.

METHODS

From January 2012 through April 2014, a total of 7 patients with spinal dural AVFs in the thoracic region underwent open microsurgical obliteration at Tokyo Metropolitan Neurological Hospital. The microvascular anatomy of spinal dural AVFs was comprehensively assessed by using advanced microangiography, including 3D computer graphics and intraoperative indocyanine green video angiography, and by histological findings.

RESULTS

The 2 microangiography techniques revealed the spatial course and in vivo blood flow of the meningeal vessels and their relationships with the dura mater in sufficient detail. The meningeal branch of the intercostal artery split into multiple meningeal vessels on the outer dural surface adjacent to the root sleeve. After crossing the dura mater to the inner dural surface, these vessels gathered and joined a single intradural draining vessel. On the inner dural surface, the single draining vessel was fed by the surrounding multiple meningeal vessels, which appeared to be caput medusae. Histological findings revealed that the structure of the meningeal branch of the intercostal artery corresponded to that of a normal artery. The structure of intradural draining vessels corresponded to that of a vein modified by retrograde arterial inflow. On the inner dural surface, more than 1 meningeal artery gathered and joined with the proximal radiculomedullary vein.

CONCLUSIONS

Spinal dural AVFs are located on the inner dural surface, where multiple direct AV connections between more than 1 meningeal feeding artery and a single proximal radiculomedullary vein occur at the site where the vein connects to the dura mater.

Authors+Show Affiliations

Departments of 1 Neurosurgery and.Laboratory Medicine and Pathology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.Departments of 1 Neurosurgery and.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26115024

Citation

Takai, Keisuke, et al. "Microvascular Anatomy of Spinal Dural Arteriovenous Fistulas: Arteriovenous Connections and Their Relationships With the Dura Mater." Journal of Neurosurgery. Spine, vol. 23, no. 4, 2015, pp. 526-33.
Takai K, Komori T, Taniguchi M. Microvascular anatomy of spinal dural arteriovenous fistulas: arteriovenous connections and their relationships with the dura mater. J Neurosurg Spine. 2015;23(4):526-33.
Takai, K., Komori, T., & Taniguchi, M. (2015). Microvascular anatomy of spinal dural arteriovenous fistulas: arteriovenous connections and their relationships with the dura mater. Journal of Neurosurgery. Spine, 23(4), 526-33. https://doi.org/10.3171/2014.11.SPINE14786
Takai K, Komori T, Taniguchi M. Microvascular Anatomy of Spinal Dural Arteriovenous Fistulas: Arteriovenous Connections and Their Relationships With the Dura Mater. J Neurosurg Spine. 2015;23(4):526-33. PubMed PMID: 26115024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Microvascular anatomy of spinal dural arteriovenous fistulas: arteriovenous connections and their relationships with the dura mater. AU - Takai,Keisuke, AU - Komori,Takashi, AU - Taniguchi,Makoto, Y1 - 2015/06/26/ PY - 2015/6/27/entrez PY - 2015/6/27/pubmed PY - 2016/1/1/medline KW - AV = arteriovenous KW - AVF = AV fistula KW - ICG = indocyanine green KW - angioarchitecture KW - arteriovenous malformation KW - arteriovenous shunt KW - dural arteriovenous fistula KW - endovascular treatment KW - pathology KW - surgical treatment KW - vascular disorders SP - 526 EP - 33 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 23 IS - 4 N2 - OBJECT The microvascular anatomy of spinal dural arteriovenous fistulas (AVFs), especially the relationships of the vessels with the dura mater, has yet to be angiographically demonstrated in detail and proven histologically. METHODS From January 2012 through April 2014, a total of 7 patients with spinal dural AVFs in the thoracic region underwent open microsurgical obliteration at Tokyo Metropolitan Neurological Hospital. The microvascular anatomy of spinal dural AVFs was comprehensively assessed by using advanced microangiography, including 3D computer graphics and intraoperative indocyanine green video angiography, and by histological findings. RESULTS The 2 microangiography techniques revealed the spatial course and in vivo blood flow of the meningeal vessels and their relationships with the dura mater in sufficient detail. The meningeal branch of the intercostal artery split into multiple meningeal vessels on the outer dural surface adjacent to the root sleeve. After crossing the dura mater to the inner dural surface, these vessels gathered and joined a single intradural draining vessel. On the inner dural surface, the single draining vessel was fed by the surrounding multiple meningeal vessels, which appeared to be caput medusae. Histological findings revealed that the structure of the meningeal branch of the intercostal artery corresponded to that of a normal artery. The structure of intradural draining vessels corresponded to that of a vein modified by retrograde arterial inflow. On the inner dural surface, more than 1 meningeal artery gathered and joined with the proximal radiculomedullary vein. CONCLUSIONS Spinal dural AVFs are located on the inner dural surface, where multiple direct AV connections between more than 1 meningeal feeding artery and a single proximal radiculomedullary vein occur at the site where the vein connects to the dura mater. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/26115024/Microvascular_anatomy_of_spinal_dural_arteriovenous_fistulas:_arteriovenous_connections_and_their_relationships_with_the_dura_mater_ L2 - https://thejns.org/doi/10.3171/2014.11.SPINE14786 DB - PRIME DP - Unbound Medicine ER -