Endovascular treatment of epidural arteriovenous fistula associated with sacral arteriovenous malformation: case report

被引:0
|
作者
Alwahdy, Ahmad Sulaiman [1 ]
机构
[1] Fatmawati Gen Cent Hosp, Dept Neurol Intervent Neurol Subdiv, Jakarta, Indonesia
来源
FRONTIERS IN NEUROLOGY | 2024年 / 15卷
关键词
arteriovenous fistula; arteriovenous malformation; embolization; endovascular; epidural; spinal; ANGIOARCHITECTURE; VEIN;
D O I
10.3389/fneur.2024.1326182
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Spinal epidural arteriovenous fistulas with sacral arteriovenous malformation (AVM) are a rare type of spinal arteriovenous fistulas. There are two varieties of spinal epidural arteriovenous fistulas (SEDAVFs), with type 1 involving intradural venous drainage and type 2 not involving intradural venous drainage. We present a case of transarterial embolization for type 1 SEDAVFs with sacral AVM. Within 8 months, a 14-year-old boy presented with progressively weaker lower extremities and bladder-bowel dysfunction. Magnetic resonance imaging (MRI) of the whole spine revealed thoracic spinal cord congestion, a single dilated flow void running from the lumbosacral area to the conus medullaris, and continuing cranial draining up to the C5 level via the perimedullary vein. Filling of the venous sac through a preferential feeder after embolizing the AVM nidus was performed. After 3 months, the clinical follow-up showed improvement of motoric function, although mild. Endovascular treatment for SEDAVF type 1 might have achieved total obliteration without any procedural complications. Nevertheless, it can be very challenging due to multiple feeders and the presence of an AVM nidus like in this case. However, the most difficult thing in fistula cases is establishing the diagnosis and finding the fistula point. Early treatment is required, due to the fact that longstanding lesions could cause irreversible damage.
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页数:6
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