Spinal Dural Arteriovenous Fistulas: Clinical Analysis In 12 Patients

BackgroundAmong the AV malformations involving the spinal cord,the dural AVF is the most common subtype.It occurs mostly in middle-aged men.Most of the cases are solitary,and multiple lesions are rare.Although the etiology has not been elucidated,the clinical symptoms are characteristic of the rogressive spastic paraparesis,themicturition problem,and the numbness of the legs or buttocks. The MRI findings are characteristic of the perimedullary serpiginous flow voids, intramedullary T2 high-intensity signal,and swelling of the spinal cord.Patients will be in a severely disabled condition withoutproper treatment.Objective and MethodsTo discuss the diagnosis and treatment of spinal dural arteriovenous fistulas,twelve patients were hospitalized for spinal dural arteriovenous fistulas in our department from September 1994 to March 2008.All patients underwent MRJ examination to obtain the image of axial and sagittal plane of spinal before operation.The diagnosis was confirmed by selective spinalangiography.Surgical interruption of arterialized radicular-medullary draining vein of SDAVF provides permanent occlusion of the fistula.ResultsImprovement occurred in 11cases.1 case no improvement.Case history affected the postoperative outcomes.ConclusionSpinal dural arteriovenous fistulae was one kind of spinal arteriovenous eratism.The clinical characteristics were progressive and bottom-up disability of motion,sen-sory。urination and defecation in both lower extremities.It was easy to be misdiagnosised because of no typical clinical features in the early phaseSDAVF could be suggestedin MRI examination.DSA examination of spinal vascular is the golden standard in diagnosis of SDAVF.Surgical interruption is elective in the treatment of SDAVF.