Skip to main content

Advertisement

SpringerLink
Log in

Spinal intradural arteriovenous fistula with unusual presentation: case report and literature review

  • Case Report
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Object

The authors present their experience with a Cervical Spinal intradural arteriovenous fistula (AVF) with unusual clinical presentation in a pediatric patient and review of the international literature on this condition.

Methods

A 5-year-old girl was found by her parents in bed screaming and talking inappropriately. Later on, she calmed down and complained of occipital, back and neck pain. She was admitted to the CHEO-ICU for work up and observation. The admission head CT scan showed evidence of SAH. Brain MRI showed blood in the third and fourth ventricles. MRA showed a C2 vascular lesion consistent with spinal cord AVF. Conventional angiogram was done which confirmed the AVF fed by a posterior medullary artery originating from the left vertebral artery. An attempt to embolize the AVF with glue was made but proved to be unsuccessful. On December 4, 2002, direct surgery on the AVF was performed, through a midline posterior approach (C2–C3 laminectomies) and microsurgical technique a complete excision of the intradural extramedullary AVF was achieved. The postoperative course was uneventful and the patient remained neurologically intact. Post-operative angiography confirmed complete excision of the AVF.

Conclusion

The rarity of a pediatric spinal AVF presenting with spontaneous Intracranial SAH, makes this case very peculiar. This is the first reported pediatric case of cervical cord AVF with this clinical presentation found in the literature.

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. Berenstein A, Lasjaunias P (1992) Spine and spinal cord vascular lesions.In: Endovascular treatment of spine and spinal cord lesions (Surgical neuroangiography, vol 5). Springer, Berlin pp 1–85

  2. Berenstein A, Lasjaunias P, TerBrugge K (2004) Spinal arteriovenous malformation of the spinal cord. In: Surgical neuroangiography, Vol 2.2. Springer, Berlin , 2004:737–847

  3. Djindjian R (1978) Clinical symptomatology and natural history of arteriovenous malformation of the spinal cord: a study of the clinical aspects and prognosis, based on 150 cases. In: Pia H, Djindjian R (eds) Spinal angiomas: advances in diagnosis and therapy. Springer, Berlin, pp 48–83

    Google Scholar 

  4. Halbach VV, Higashida RT, Dowd CF, Fraser KW, Edwards MS, Barnwell SL (1993) Treatment of giant intradural (perimedullary) arteriovenous fistulas. Neurosurgery 33:972–980

    Article  PubMed  CAS  Google Scholar 

  5. Ikeda H, Fujimoto Y, Koyama T, Fujimoto Y (1994) A rare case of high cervical spinal cord dural arteriovenous fistula presenting with intracranial subarachnoid hemorrhage. No Shinkei Geka 22(11):1045–1048 Nov

    PubMed  CAS  Google Scholar 

  6. Ricolfi F, Gobin PY, Aymard A, Brunelle F, Gaston A, Merland JJ (1997) Giant perimedullary arteriovenous fistulas of the spine: clinical and radiological features and endovascular treatment. AJNR Am J Neuroradiol 18:677–687

    PubMed  CAS  Google Scholar 

  7. Rodesch G, Pongpech S, Alvarez H, Zerah M, Hurth M, Sebire G, Lasjaunias P (1995) Spinal cord arteriovenous malformations in a pediatric population/children below 15 years of age/the place of endovascular management. Intervent Neuroradiol 1:29–42

    Google Scholar 

  8. Spetzler RF, Detwiler PW, Riina HA et al (2002) Modified classification of spinal cord vascular lesions. J Neurosurg 96(2 Suppl):145–156

    PubMed  Google Scholar 

  9. Tacconi L, Findlay G (2000) Spinal dural arterio-venous fistula malformations. Neurosurg Quart 10(2):100–116

    Google Scholar 

  10. Tomlinson FH, Rüfenacht DA, Sundt TM Jr, Nichols DA, Fode NC (1994) Arteriovenous fistulas of the brain and the spinal cord. J Neurosurg 80(1):178–179 Jan

    Google Scholar 

  11. Yasargil GM, DeLong BW, Guarnaschelli JJ (1975) Complete microsurgical excision of cervical extramedullary and intramedullary vascular malformations. Surg Neurol 4:211–224

    PubMed  CAS  Google Scholar 

  12. Yasargil MG, Symon L, Teddy PJ (1984) Arterio-venous malformations of the spinal cord. Adv Tech Stand Neurosurg 11:61–101

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Neurosurgery, Children’s Hospital of Eastern Ontario, 401 Smyth, Ottawa, ON, K1H 8L1, Canada

    Luis Alonso Fernández, Munyao Nzau & Enrique Ventureyra

  2. University of Ottawa, Ottawa, ON, Canada

    Luis Alonso Fernández, Munyao Nzau & Enrique Ventureyra

Authors
  1. Luis Alonso Fernández
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Munyao Nzau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Enrique Ventureyra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Enrique Ventureyra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alonso Fernández, L., Nzau, M. & Ventureyra, E. Spinal intradural arteriovenous fistula with unusual presentation: case report and literature review. Childs Nerv Syst 24, 1349–1353 (2008). https://doi.org/10.1007/s00381-008-0656-y

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-008-0656-y

Keywords

Search

Navigation