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Salvageable Intra-stent Coil Embolization Treatment for Spinal Dural Arteriovenous Fistula in a Child
Abdullah S Almawi1, Abdulaziz S Alhammad2, Zaid A Alshammari3
1Radiology, Security Forces Hospital, Riyadh, SAU.
Insights
Spinal dural arteriovenous fistulae (SDAVF) are rare vascular malformations. Successful endovascular stenting and coiling in a pediatric patient demonstrate effective treatment for this challenging condition.
Area of Science:
- Neurology
- Vascular Surgery
- Pediatric Neurosurgery
Background:
- Spinal dural arteriovenous fistulae (SDAVF) are uncommon vascular anomalies characterized by abnormal connections between spinal arteries and veins.
- SDAVF are exceptionally rare in children, presenting unique diagnostic and therapeutic challenges.
Observation:
- A four-year-old girl presented with progressive bilateral lower limb weakness, a rare initial symptom of SDAVF.
- The patient's condition required specialized neurovascular intervention due to its rarity in the pediatric population.
Findings:
- Successful treatment of the pediatric SDAVF was achieved through primary major fistula point stenting and intra-stent coiling.
- Complete closure of the fistula was confirmed, leading to a full recovery in the patient.
Implications:
- This case highlights the efficacy of advanced endovascular techniques in managing complex pediatric spinal neurovascular pathologies.
- A multidisciplinary neurovascular team approach is crucial for optimal outcomes in treating rare SDAVF cases.
Abstract:
Spinal dural arteriovenous fistulae (SDAVF) are rare diseases that exhibit abnormal connections between arteries and veins. They are even rarer in the pediatric population and pose diagnostic and treatment challenges for physicians. Its presentation varies depending on the site and size of the SDAVF. Multiple management options are available, which are usually tailored depending on the patient's condition. Here, we present a rare case of SDAF in a four-year-old girl who initially presented with bilateral lower limb weakness. The patient was then treated successfully using primary major fistula point stenting and intra-stent coiling, with complete closure achieved. Full recovery was achieved over the course of follow-ups. The deep analysis of SDAVF, its classification, and the utilization of the best available endovascular tools by a dedicated neurovascular team offer the best outcome in dealing with complex spinal neurovascular pathologies.
