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[Spinal dural arteriovenous fistulas].

A Thron1

  • 1Abt. Neuroradiologie, Universitätsklinikum der RWTH, Pauwelsstr. 30, 52074 Aachen.

Der Radiologe
|January 5, 2002
PubMed
Summary

Spinal dural arteriovenous fistulas (SDAVF) cause progressive myelopathy, often missed in elderly men. Early diagnosis via MRI and angiography is crucial for effective treatment like embolization or surgery.

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Area of Science:

  • Neurology
  • Vascular Surgery
  • Radiology

Context:

  • Spinal dural arteriovenous fistula (SDAVF) is a rare condition causing progressive sensorimotor deficits, primarily affecting elderly males.
  • It results from an abnormal connection between dural arteries and spinal veins, leading to venous congestion and myelopathy.
  • The incidence is low, estimated at 5-10 new cases per million inhabitants annually, underscoring the need for awareness.

Purpose:

  • To highlight the importance of recognizing and diagnosing spinal dural arteriovenous fistulas (SDAVF).
  • To outline the diagnostic modalities, including MRI and spinal angiography.
  • To discuss treatment options and emphasize the impact of early intervention.

Summary:

  • SDAVF presents as a slowly progressive sensorimotor transverse lesion, predominantly in elderly men (80% of cases).
  • Diagnosis relies on MRI to visualize congestive myelopathy and spinal angiography for precise localization of the arteriovenous shunt within the dura.
  • Treatment involves either selective embolization of the fistula or surgical disconnection, with outcomes dependent on early diagnosis.

Impact:

  • Early diagnosis and treatment of SDAVF can prevent irreversible neurological damage and improve patient outcomes.
  • Increased awareness among clinicians can lead to timely diagnosis, reducing diagnostic delays for this rare condition.
  • Effective management strategies, including embolization and surgery, offer viable therapeutic options for patients with SDAVF.

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