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Asymptomatic spinal dural arteriovenous fistulas: pathomechanical considerations
Kenichi Sato1, Karel G Terbrugge, Timo Krings
1Department of Medical Imaging, Toronto Western Hospital, University of Toronto, Ontario, Canada.
Journal of Neurosurgery. Spine
|March 6, 2012
Summary
Obstruction of radicular venous outflow in spinal dural arteriovenous fistulas (SDAVFs) may cause symptomatic venous hypertension and spinal cord edema. Asymptomatic SDAVFs show alternative venous drainage, preventing these complications.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Spinal dural arteriovenous fistulas (SDAVFs) cause myelopathy via venous hypertension.
- The role of venous outflow obstruction in SDAVF symptom development is unclear.
Observation:
- Compared asymptomatic and symptomatic SDAVFs at the thoracic level.
- Assessed clinical and imaging findings, including spinal cord edema and venous drainage patterns.
Findings:
- Symptomatic SDAVFs showed spinal cord edema and venous hypertension.
- Asymptomatic SDAVFs had younger patients and distinct early radicular venous outflow to the extradural plexus.
- This alternative outflow may relieve venous hypertension.
Implications:
- Radicular venous outflow obstruction is a key factor in SDAVF-induced venous hypertension and myelopathy.
- Understanding these drainage patterns can inform treatment strategies for SDAVFs.
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