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Surgical management of angiographically occult spinal dural arteriovenous fistulae (type I spinal arteriovenous
C H Alleyne1, D L Barrow, G Joseph
1Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Objective And Importance:
Spinal dural arteriovenous fistulae (Type I spinal arteriovenous malformations [AVMs]) have been recognized as a treatable cause of progressive myelopathy. The diagnosis and characterization of these lesions rest heavily on spinal angiography.
Clinical Presentation:
We present three patients whose clinical presentations were consistent with a spinal dural AVM but whose spinal angiographic results were negative.
Intervention:
The surgical treatment of these angiographically occult spinal AVMs is described. In retrospect, in each case, the feeding vessel to the AVM was injected but not seen.
Conclusion:
Some spinal dural arteriovenous fistulae will be angiographically occult. If the clinical and radiographic presentations strongly suggest the presence of an arteriovenous fistula, surgical exploration should be considered.