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Rare Spinal Dural Arteriovenous Fistula with Double Draining Veins: 1 Draining Vein Mimicking Artery of Adamkiewicz: Case Report and Review of Literature.
World Neurosurg. 2020 Jan; 133:29-33.WN

Abstract

BACKGROUND

Spinal dural arteriovenous fistula (DAVF) typically has a single intradural drainage vein, abnormally connecting with the radiculomeningeal artery at the dura root sleeve. Multiple intradural draining veins are extremely rare. To date, only 1 case of spinal DAVF with multiple draining veins has been reported.

CASE DESCRIPTION

A 62-year-old woman presented with a 2-year history of progressive weakness and numbness in her lower extremities. Spinal magnetic resonance imaging showed extensive edema of the cord and prominent vascular flow voids. Spinal angiography demonstrated a right L3 DAVF with supply from the left L3 lumbar artery. The feeding artery was also thought to give rise to the artery of Adamkiewicz. The spinal DAVF was surgically treated, and the artery of Adamkiewicz was retained. Her postoperative symptoms gradually improved. Eight months after the surgery, her symptoms gradually worsened. Repeat spinal angiography revealed a right L3 DAVF at the same location of the first fistula. In retrospect, the draining vein identified on the second angiography was mistakenly considered as the artery of Adamkiewicz at the first angiography. Therefore the initial fistula was drained through double draining veins, 1 of them mimicking the artery of Adamkiewicz. The fistula was coagulated and divided. Postoperatively, the patient's symptoms gradually improved. Three months after the second surgery, she was able to walk independently.

CONCLUSIONS

Spinal DAVF is a rare disease, but clinicians should be cautious of possible multiple drainage veins in diagnosis and treatment.

Authors+Show Affiliations

Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, P. R. China.Department of Anesthesia and Operation Room, West China Hospital of Sichuan University, Chengdu, Sichuan, P. R. China.Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, P. R. China.Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, P. R. China.Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, P. R. China. Electronic address: lijinwestchina@126.com.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31526887

Citation

Niu, Xiaodong, et al. "Rare Spinal Dural Arteriovenous Fistula With Double Draining Veins: 1 Draining Vein Mimicking Artery of Adamkiewicz: Case Report and Review of Literature." World Neurosurgery, vol. 133, 2020, pp. 29-33.
Niu X, Lin J, Liu H, et al. Rare Spinal Dural Arteriovenous Fistula with Double Draining Veins: 1 Draining Vein Mimicking Artery of Adamkiewicz: Case Report and Review of Literature. World Neurosurg. 2020;133:29-33.
Niu, X., Lin, J., Liu, H., Ren, Y., & Li, J. (2020). Rare Spinal Dural Arteriovenous Fistula with Double Draining Veins: 1 Draining Vein Mimicking Artery of Adamkiewicz: Case Report and Review of Literature. World Neurosurgery, 133, 29-33. https://doi.org/10.1016/j.wneu.2019.09.050
Niu X, et al. Rare Spinal Dural Arteriovenous Fistula With Double Draining Veins: 1 Draining Vein Mimicking Artery of Adamkiewicz: Case Report and Review of Literature. World Neurosurg. 2020;133:29-33. PubMed PMID: 31526887.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rare Spinal Dural Arteriovenous Fistula with Double Draining Veins: 1 Draining Vein Mimicking Artery of Adamkiewicz: Case Report and Review of Literature. AU - Niu,Xiaodong, AU - Lin,Jun, AU - Liu,Hao, AU - Ren,Yanming, AU - Li,Jin, Y1 - 2019/09/14/ PY - 2019/06/09/received PY - 2019/09/08/revised PY - 2019/09/09/accepted PY - 2019/9/19/pubmed PY - 2020/1/29/medline PY - 2019/9/19/entrez KW - Artery of Adamkiewicz KW - Draining veins KW - Spinal dural arteriovenous fistula KW - Surgery SP - 29 EP - 33 JF - World neurosurgery JO - World Neurosurg VL - 133 N2 - BACKGROUND: Spinal dural arteriovenous fistula (DAVF) typically has a single intradural drainage vein, abnormally connecting with the radiculomeningeal artery at the dura root sleeve. Multiple intradural draining veins are extremely rare. To date, only 1 case of spinal DAVF with multiple draining veins has been reported. CASE DESCRIPTION: A 62-year-old woman presented with a 2-year history of progressive weakness and numbness in her lower extremities. Spinal magnetic resonance imaging showed extensive edema of the cord and prominent vascular flow voids. Spinal angiography demonstrated a right L3 DAVF with supply from the left L3 lumbar artery. The feeding artery was also thought to give rise to the artery of Adamkiewicz. The spinal DAVF was surgically treated, and the artery of Adamkiewicz was retained. Her postoperative symptoms gradually improved. Eight months after the surgery, her symptoms gradually worsened. Repeat spinal angiography revealed a right L3 DAVF at the same location of the first fistula. In retrospect, the draining vein identified on the second angiography was mistakenly considered as the artery of Adamkiewicz at the first angiography. Therefore the initial fistula was drained through double draining veins, 1 of them mimicking the artery of Adamkiewicz. The fistula was coagulated and divided. Postoperatively, the patient's symptoms gradually improved. Three months after the second surgery, she was able to walk independently. CONCLUSIONS: Spinal DAVF is a rare disease, but clinicians should be cautious of possible multiple drainage veins in diagnosis and treatment. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/31526887/Rare_Spinal_Dural_Arteriovenous_Fistula_with_Double_Draining_Veins:_1_Draining_Vein_Mimicking_Artery_of_Adamkiewicz:_Case_Report_and_Review_of_Literature L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(19)32480-5 DB - PRIME DP - Unbound Medicine ER -