Endovascular treatment of a spinal dural arteriovenous malformation (DAVF)

Vijay AgarwalDivision of Neurosurgery, Duke University Medical Center, Durham, North Carolina; and

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Ali ZomorodiDivision of Neurosurgery, Duke University Medical Center, Durham, North Carolina; and

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Pascal JabbourDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania

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Nohra ChalouhiDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania

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Stavropoula TjoumakarisDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania

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Ranjith BabuDivision of Neurosurgery, Duke University Medical Center, Durham, North Carolina; and

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Adam BackDivision of Neurosurgery, Duke University Medical Center, Durham, North Carolina; and

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L. Fernando GonzalezDivision of Neurosurgery, Duke University Medical Center, Durham, North Carolina; and

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We present a case of a patient with rapid loss of motor strength in his lower extremities. He became bedridden with bowel and bladder incontinence, and developed saddle anesthesia. MRI of the lumbar spine showed edema in the conus medullaris and multiple flow voids within the spinal canal. A spinal angiogram showed a dorsal Type I spinal AVF. This was treated successfully with Onyx 18 (eV3, Irvine, CA). The patient showed rapid post-procedure improvement, and at discharge from the hospital to a rehabilitation center he was fully ambulatory. At 3-year follow-up, the patient was found to ambulate without difficulty. He also had improved saddle anesthesia, and he was voiding spontaneously. There was no evidence of flow voids on repeat MRI of the lumbar spine.

The video can be found here: http://youtu.be/SDYNIGNQIW8.

We present a case of a patient with rapid loss of motor strength in his lower extremities. He became bedridden with bowel and bladder incontinence, and developed saddle anesthesia. MRI of the lumbar spine showed edema in the conus medullaris and multiple flow voids within the spinal canal. A spinal angiogram showed a dorsal Type I spinal AVF. This was treated successfully with Onyx 18 (eV3, Irvine, CA). The patient showed rapid post-procedure improvement, and at discharge from the hospital to a rehabilitation center he was fully ambulatory. At 3-year follow-up, the patient was found to ambulate without difficulty. He also had improved saddle anesthesia, and he was voiding spontaneously. There was no evidence of flow voids on repeat MRI of the lumbar spine.

The video can be found here: http://youtu.be/SDYNIGNQIW8.

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