Report of a spinal extradural arteriovenous fistula with double radiculomedullary venous drainage: therapeutic implications and role of intraoperative spinal angiography

View More View Less
  • 1 Department of Neurosurgery and
  • 2 Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, Maryland
Restricted access

Purchase Now

USD  $45.00

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

Low-flow spinal extradural arteriovenous fistulas (SEAVFs) are frequently misdiagnosed as spinal dural arteriovenous fistulas (SDAVFs), and their true prevalence is unknown. The principal feature distinguishing low-flow SEAVFs from SDAVFs is the location of the shunt, which involves a pouch of epidural plexus in SEAVFs and a radiculomedullary vein (RMV) in SDAVFs. A venous hypertensive myelopathy comparable to the one observed with SDAVFs develops when the arterialized venous pouch of an SEAVF is connected to an RMV. Depending on the size of the epidural pouch, a low-flow SEAVF may uncommonly drain into multiple RMVs. The authors present an observation of a low-flow SEAVF whose double radiculomedullary drainage was revealed only after intraoperative digital subtraction angiography, and they discuss the surgical implications of this anatomical configuration.

ABBREVIATIONS ICG = indocyanine green; RMV = radiculomedullary vein; SDAVF = spinal dural arteriovenous fistula; SEAVF = spinal extradural arteriovenous fistula; SpDSA = spinal digital subtraction angiography; VHM = venous hypertensive myelopathy.

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Correspondence Philippe Gailloud: The Johns Hopkins Hospital, Baltimore, MD. phg@jhmi.edu.

INCLUDE WHEN CITING Published online February 5, 2021; DOI: 10.3171/2020.8.SPINE20967.

Disclosures Dr. Gailloud: consultant for Cerenovus.

  • 1

    Kang J, Gregg L, Gailloud P. Spontaneous resolution of low-flow spinal arteriovenous fistulas. Neuroradiology. 2017;59(10):10031012.

  • 2

    Merland JJ, Riche MC, Chiras J. Intraspinal extramedullary arteriovenous fistulae draining into the medullary veins. J Neuroradiol. 1980;7(4):271320.

    • Search Google Scholar
    • Export Citation
  • 3

    Shankar JJ, terBrugge K, Krings T. Spinal epidural arteriovenous fistula with double perimedullary reflux. Can J Neurol Sci. 2012;39(2):239241.

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 584 584 584
Full Text Views 27 27 27
PDF Downloads 16 16 16
EPUB Downloads 0 0 0