Journal of Neurology

, Volume 253, Issue 2, pp 159–162 | Cite as

Spinal dural arteriovenous fistulas—An underdiagnosed disease

A review of patients admitted to the spinal unit of a rehabilitation center
  • K. JellemaEmail author
  • C. C. Tijssen
  • M. Sluzewski
  • F. W. A. van Asbeck
  • P. J. Koudstaal
  • J. van Gijn



Spinal dural arteriovenous fistulas (SDAVF) are rare and present with non–specific symptoms. The diagnosis is difficult and it is therefore conceivable that patients may not be recognized.


We reviewed the intake forms of patients who had been admitted to the spinal cord injury ward of a rehabilitation center in the period 1980–2004 to identify possible patients with an undiagnosed SDAVF. Clinical and radiological data were evaluated in selected cases.


In 20 of 1429 newly admitted patients to the rehabilitation center (in 614 of whom trauma was not the cause), we restudied the CT myelograms, MRI scans or spinal angiograms and in two of these we found an undiagnosed SDAVF, and one cerebral dural arteriovenous fistula. One of these three was diagnosed with SDAVF 8 years after the admission to the rehabilitation center; the other two patients had never been diagnosed with SDAVF. In 9 patients a diagnosis of SDAVF had already been established by the time they were admitted to the spinal cord unit. In 20 other patients the admission diagnosis was a vascular lesion or 'progressive myelopathy' but appropriate radiological studies had been destroyed or had never been performed.


Our results suggest that spinal dural arteriovenous fistulas are an underdiagnosed condition.

Key words

spinal dural arteriovenous fistulas undiagnosed rehabilitation center 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Asakawa H, Yanaka K, Fujita K, Marushima A, Anno I, Nose T (2002) Intracranial dural arteriovenous fistula showing diffuse MR enhancement of the spinal cord: case report and review of the literature. Surg Neurol 58:251–257PubMedGoogle Scholar
  2. 2.
    Brunereau L, Gobin YP, Meder JF, Cognard C, Tubiana JM, Merland JJ (1996) Intracranial dural arteriovenous fistulas with spinal venous drainage: relation between clinical presentation and angiographic findings. Am J Neuroradiol 17:1549–1554PubMedGoogle Scholar
  3. 3.
    Gilbertson JR, Miller GM, Goldman MS, Marsh WR (1995) Spinal dural arteriovenous fistulas: MR and myelographic findings. AJNR Am J Neuroradiol 16:2049–2057PubMedGoogle Scholar
  4. 4.
    Gobin YP, Rogopoulos A, Aymard A, Khayata M, Reizine D, Chiras J, Merland JJ (1992) Endovascular treatment of intracranial dural arteriovenous fistulas with spinal perimedullary venous drainage. J Neurosurg 77:718–723PubMedGoogle Scholar
  5. 5.
    Grandin C, Duprez T, Stroobandt G, Laterre EC, Mathurin P (1997) Spinal dural arterio–venous fistula: an underdiagnosed disease? Acta Neurol Belg 97:17–21PubMedGoogle Scholar
  6. 6.
    Jellema K, Canta LR, Tijssen CC, van Rooij WJ, Koudstaal PJ, van Gijn J (2003) Spinal dural arteriovenous fistulas: clinical features in 80 patients. J Neurol Neurosurg Psychiatry 74:1438–1440CrossRefPubMedGoogle Scholar
  7. 7.
    Jellema K, Tijssen CC, van Rooij WJ, Sluzewski M, Koudstaal PJ, Algra A, van Gijn J (2004) Spinal dural arteriovenous fistulas: long–term follow–up of 44 treated patients. Neurology 62:1839–1841PubMedGoogle Scholar
  8. 8.
    Kendall BE, Logue V (1977) Spinal epidural angiomatous malformations draining into intrathecal veins. Neuroradiology 13:181–189PubMedGoogle Scholar

Copyright information

© Steinkopff-Verlag 2005

Authors and Affiliations

  • K. Jellema
    • 5
    Email author
  • C. C. Tijssen
    • 5
  • M. Sluzewski
    • 1
  • F. W. A. van Asbeck
    • 2
  • P. J. Koudstaal
    • 3
  • J. van Gijn
    • 4
  1. 1.Dept. of NeuroradiologySt. Elisabeth HospitalTilburgThe Netherlands
  2. 2.Rehabilitation center 'De Hoogstraat'UtrechtThe Netherlands
  3. 3.Dept. of NeurologyErasmus Medical CenterRotterdamThe Netherlands
  4. 4.Dept. of NeurologyUniversity Medical CenterUtrechtThe Netherlands
  5. 5.St. Elisabeth ZiekenhuisLC TilburgThe Netherlands

Personalised recommendations