Tags

Type your tag names separated by a space and hit enter

Concomitant Lumbosacral Perimedullary Arteriovenous Fistula and Spinal Dural Arteriovenous Fistula.
World Neurosurg. 2017 Sep; 105:1041.e7-1041.e14.WN

Abstract

BACKGROUND

Although multifocal spinal arteriovenous malformations (AVMs) have been reported before, the present case is the first case of 2 different types, including 1 perimedullary arteriovenous fistula and 2 spinal dural arteriovenous fistulas of lumbosacral AVMs, coexisting in 1 patient. We also report the use of hybrid techniques in treatment of concomitant lumbosacral spinal AVMs.

CASE DESCRIPTION

A 65-year-old man presented with a 4-year history of progressive sensory, motor, and sphincter dysfunction. Spinal magnetic resonance imaging and digital subtraction angiography showed 2 spinal dural arteriovenous fistulas (fed by the right L2 lumbar artery and the right lateral sacral artery, respectively) and 1 perimedullary arteriovenous fistula (fed by the filum terminale artery from the left L2 lumbar artery [i.e., filum terminale arteriovenous fistulas]. A hybrid technique was used to perform embolization of the right L2 spinal dural arteriovenous fistula and microsurgery of the L5 level filum terminale vein. The patient was asymptomatic 1 year later.

CONCLUSIONS

Multifocal spinal vascular malformations may coexist in 1 case, and standardized spinal digital subtraction angiography, including the bilateral internal iliac arteries and median sacral artery, should be performed to avoid a missed diagnosis. The concomitant phenomenon indicates that venous hypertension may be a risk factor for the development of arteriovenous fistulas. Hybrid techniques are effective in treatment of multifocal and complex spinal AVMs.

Authors+Show Affiliations

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.Department of Neurosurgery, Beijing Haidian section of Peking University Third Hospital, Beijing, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. Electronic address: feng_ling_ccmu@163.com.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28684369

Citation

Li, Jingwei, et al. "Concomitant Lumbosacral Perimedullary Arteriovenous Fistula and Spinal Dural Arteriovenous Fistula." World Neurosurgery, vol. 105, 2017, pp. 1041.e7-1041.e14.
Li J, Li G, Bian L, et al. Concomitant Lumbosacral Perimedullary Arteriovenous Fistula and Spinal Dural Arteriovenous Fistula. World Neurosurg. 2017;105:1041.e7-1041.e14.
Li, J., Li, G., Bian, L., Hong, T., Yu, J., Zhang, H., & Ling, F. (2017). Concomitant Lumbosacral Perimedullary Arteriovenous Fistula and Spinal Dural Arteriovenous Fistula. World Neurosurgery, 105, e7-e14. https://doi.org/10.1016/j.wneu.2017.06.149
Li J, et al. Concomitant Lumbosacral Perimedullary Arteriovenous Fistula and Spinal Dural Arteriovenous Fistula. World Neurosurg. 2017;105:1041.e7-1041.e14. PubMed PMID: 28684369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Concomitant Lumbosacral Perimedullary Arteriovenous Fistula and Spinal Dural Arteriovenous Fistula. AU - Li,Jingwei, AU - Li,Guilin, AU - Bian,Lisong, AU - Hong,Tao, AU - Yu,Jiaxing, AU - Zhang,Hongqi, AU - Ling,Feng, Y1 - 2017/07/04/ PY - 2017/01/08/received PY - 2017/06/22/revised PY - 2017/06/24/accepted PY - 2017/7/8/pubmed PY - 2017/10/4/medline PY - 2017/7/8/entrez KW - Filum terminale KW - Hybrid operation KW - Lumbosacral KW - Methylene blue KW - Pathogenesis KW - Perimedullary arteriovenous fistula KW - Spinal dural arteriovenous fistula SP - 1041.e7 EP - 1041.e14 JF - World neurosurgery JO - World Neurosurg VL - 105 N2 - BACKGROUND: Although multifocal spinal arteriovenous malformations (AVMs) have been reported before, the present case is the first case of 2 different types, including 1 perimedullary arteriovenous fistula and 2 spinal dural arteriovenous fistulas of lumbosacral AVMs, coexisting in 1 patient. We also report the use of hybrid techniques in treatment of concomitant lumbosacral spinal AVMs. CASE DESCRIPTION: A 65-year-old man presented with a 4-year history of progressive sensory, motor, and sphincter dysfunction. Spinal magnetic resonance imaging and digital subtraction angiography showed 2 spinal dural arteriovenous fistulas (fed by the right L2 lumbar artery and the right lateral sacral artery, respectively) and 1 perimedullary arteriovenous fistula (fed by the filum terminale artery from the left L2 lumbar artery [i.e., filum terminale arteriovenous fistulas]. A hybrid technique was used to perform embolization of the right L2 spinal dural arteriovenous fistula and microsurgery of the L5 level filum terminale vein. The patient was asymptomatic 1 year later. CONCLUSIONS: Multifocal spinal vascular malformations may coexist in 1 case, and standardized spinal digital subtraction angiography, including the bilateral internal iliac arteries and median sacral artery, should be performed to avoid a missed diagnosis. The concomitant phenomenon indicates that venous hypertension may be a risk factor for the development of arteriovenous fistulas. Hybrid techniques are effective in treatment of multifocal and complex spinal AVMs. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/28684369/Concomitant_Lumbosacral_Perimedullary_Arteriovenous_Fistula_and_Spinal_Dural_Arteriovenous_Fistula_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(17)31046-X DB - PRIME DP - Unbound Medicine ER -