Skip to main content

Advertisement

SpringerLink
Log in

Spinal extradural arteriovenous fistula with intradural drainage: three surgical cases with long-term follow-up

  • Case Report - Vascular
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Spinal extradural arteriovenous fistulas (SEDAVF) with intradural drainage are uncommon vascular lesions that cause venous congestive myelopathy. We present three SEDAVF with intradural drainage treated with surgical disconnection of the intradural drainage via a single level laminectomy, followed by transarterial embolization (TAE) with Onyx if spontaneous thrombosis of the extradural fistula did not occur spontaneously. All patients improved their neurological condition and no congestive myelopathy recurrence was noted after mean follow-up of 84 months. We believe that SEDAVF with intradural drainage constitute a specific entity that should be included in the classifications of spinal arteriovenous malformations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Adamczyk P, Amar AP, Mack WJ, Larsen DW (2012) Recurrence of “cured” dural arteriovenous fistulas after Onyx embolization. Neurosurg Focus 32:E12

    Article  PubMed  PubMed Central  Google Scholar 

  2. Aminoff M, Logue V (1974) Clinical features of spinal vascular malformations. Brain 97:197–210

  3. Aminoff M, Logue V (1974) The prognosis of patients with spinal vascular malformations. Brain 97:211–218

    Article  CAS  PubMed  Google Scholar 

  4. Arnaud O, Bille F, Pouget J, Serratrice G, Salamon G (1994) Epidural arteriovenous fistula with perimedullary venous drainage: case report. Neuroradiology 36:490–491

    Article  CAS  PubMed  Google Scholar 

  5. Clarke MJ, Patrick TA, White JB, Cloft HJ, Krauss WE, Lindell E, Piepgras DG (2009) Spinal extradural arteriovenous malformations with parenchymal drainage: venous drainage variability and implications in clinical manifestations. Neurosurg Focus 26:E5

    Article  PubMed  Google Scholar 

  6. Cognard C, Semaan H, Bakchine S, Miaux Y, Thibault S, Martinez MS, Chiras J (1995) Paraspinal arteriovenous fistula with perimedullary venous drainage. Am J Neuroradiol 16:2044–2048

    CAS  PubMed  Google Scholar 

  7. Ducruet AF, Crowley RW, McDougall CG, Albuquerque FC (2013) Endovascular management of spinal arteriovenous malformations. J Neurointervention Surg 5:605–611

    Article  Google Scholar 

  8. Goyal M, Willinsky R, Montanera W (1999) Paravertebral arteriovenous malformations with epidural drainage: clinical spectrum, imaging features, and results of treatment. Am J Neuroradiol 20:749–755

    CAS  PubMed  Google Scholar 

  9. Huang W, Gross BA, Du R (2013) Spinal extradural arteriovenous fistulas: clinical article. J Neurosurg Spine 19:582–590

    Article  PubMed  Google Scholar 

  10. Jellema K, Tijssen C, Van Gijn J (2006) Spinal dural arteriovenous fistulas: a congestive myelopathy that initially mimics a peripheral nerve disorder. Brain 129:3150–3164

    Article  CAS  PubMed  Google Scholar 

  11. Kawabori M, Hida K, Yano S, Asano T, Iwasaki Y (2009) Cervical epidural arteriovenous fistula with radiculopathy mimicking cervical spondylosis. Neurol Med Chir 49:108–113

    Article  Google Scholar 

  12. Kim LJ, Spetzler RF (2006) Classification and surgical management of spinal arteriovenous lesions: arteriovenous fistulae and arteriovenous malformations. Neurosurgery 59:S3–S195

    Google Scholar 

  13. Krings T, Mull M, Bostroem A, Otto J, Hans FJ, Thron A (2006) Spinal epidural arteriovenous fistula with perimedullary drainage: case report and pathomechanical considerations. J Neurosurg Spine 5:353–358

    Article  PubMed  Google Scholar 

  14. Lanzino G, D’Urso PI, Kallmes DF, Cloft HJ (2012) Onyx embolization of extradural spinal arteriovenous malformations with intradural venous drainage. Neurosurgery 70:329–333

    Article  PubMed  Google Scholar 

  15. Muralidharan R, Mandrekar J, Lanzino G, Atkinson JL, Rabinstein AA (2013) Prognostic value of clinical and radiological signs in the postoperative outcome of spinal dural arteriovenous fistula. Spine 38:1188–1193

    Article  PubMed  Google Scholar 

  16. Narvid J, Hetts SW, Larsen D, Neuhaus J, Singh TP, McSwain H, Lawton MT, Dowd CF, Higashida RT, Halbach VV (2008) Spinal dural arteriovenous fistulae: clinical features and long-term results. Neurosurgery 62:159–167

    Article  PubMed  Google Scholar 

  17. Niizuma K, Endo T, Sato K, Takada S, Sugawara T, Mikawa S, Tominaga T (2013) Surgical treatment of spinal extradural arteriovenous fistula with parenchymal drainage: report on 5 cases. Neurosurgery 73:onsE287–onsE294

    PubMed  Google Scholar 

  18. Pirouzmand F, Wallace MC, Willinsky R (1997) Spinal epidural arteriovenous fistula with intramedullary reflux: case report. J Neurosurg 87:633–635

    Article  CAS  PubMed  Google Scholar 

  19. Ramanathan D, Levitt MR, Sekhar LN, Kim LJ, Hallam DK, Ghodke BV (2013) Management of spinal epidural arteriovenous fistulas: interventional techniques and results. J Neurointervention Surg 6(2):144–149

  20. Rangel-Castilla L, Holman PJ, Krishna C, Trask TW, Klucznik RP, Diaz OM (2011) Spinal extradural arteriovenous fistulas: a clinical and radiological description of different types and their novel treatment with Onyx: clinical article. J Neurosurg Spine 15:541–549

    Article  PubMed  Google Scholar 

  21. Reul J, Braun V (2007) Spinal arteriovenous epidural fistula with acute paraplegia: diagnosis and neurointerventional emergency treatment. a case report. Intervention Neuroradiol 13:75

    Article  CAS  Google Scholar 

  22. Saito A, Takahashi T, Ezura M, Tominaga T (2007) Intercostal arteriovenous fistula associated with neurofibromatosis manifesting as congestive myelopathy: case report. Neurosurgery 61:E656–E657

    Article  PubMed  Google Scholar 

  23. Shankar JJS, terBrugge K, Krings T (2012) Spinal epidural arteriovenous fistula with double perimedullary reflux. Canadian J Neurologic Sci 39:239–241

    Article  Google Scholar 

  24. Silva N Jr, Januel AC, Tall P, Cognard C (2007) Spinal epidural arteriovenous fistulas associated with progressive myelopathy: report of four cases. J Neurosurg Spine 6:552–558

    PubMed  Google Scholar 

  25. Spetzler RF, Detwiler PW, Riina HA, Porter RW (2002) Modified classification of spinal cord vascular lesions. J Neurosurg Spine 96:145–156

    Article  Google Scholar 

  26. Suh DC, Choi CG, Sung KB, Kim K-K, Rhim SC (2004) Spinal osseous epidural arteriovenous fistula with multiple small arterial feeders converging to a round fistular nidus as a target of venous approach. Am J Neuroradiol 25:69–73

    Google Scholar 

  27. Symon L, Kuyama H, Kendall B (1984) Dural arteriovenous malformations of the spine: clinical features and surgical results in 55 cases. J Neurosurg 60:238–247

    Article  CAS  PubMed  Google Scholar 

  28. Tacconi BLI, Symon LL (1997) Outcome and prognostic factors in the surgical treatment of spinal dural arteriovenous fistulas. a long-term study. Br J Neurosurg 11:298–305

    Article  CAS  PubMed  Google Scholar 

  29. Takai K, Taniguchi M (2012) Comparative analysis of spinal extradural arteriovenous fistulas with or without intradural venous drainage: a systematic literature review. Neurosurg Focus 32:E8

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Hospital Universitario Basurto, Avenida de Montevideo 18, 48013, Bilbao, Biscay, Spain

    Enrique J. Vázquez, Joaquín Gefaell, Leticia Fernandez, Eva López, Eduardo Areitio & Jose A. Elexpuru

  2. Department of Neurosurgery, Clínica IMQ Zorrotzaurre, Bilbao, Biscay, Spain

    Enrique J. Vázquez, Joaquín Gefaell, Eva López & Eduardo Areitio

Authors
  1. Enrique J. Vázquez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joaquín Gefaell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Leticia Fernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eva López
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eduardo Areitio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jose A. Elexpuru
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Enrique J. Vázquez.

Ethics declarations

Disclosure

The authors declare that they have no conflicts of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vázquez, E.J., Gefaell, J., Fernandez, L. et al. Spinal extradural arteriovenous fistula with intradural drainage: three surgical cases with long-term follow-up. Acta Neurochir 159, 1107–1111 (2017). https://doi.org/10.1007/s00701-017-3150-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-017-3150-z

Keywords

Search

Navigation