Abstract
Background
Spinal arteriovenous fistula (AVF) represents the most common type of spinal vascular lesions and is often associated with progressive neurological dysfunction.
Method
Here, we present a unique case of a spinal vascular malformation that does not fit the traditional classification schemes. The patient presented with progressive neurologic deficits resembling partial Brown-Sequard syndrome and was subsequently found to have a lesion resembling type I spinal AVF. However, this intradural fistula drained into the ventral venous plexus rather than dorsal.
Conclusion
Recognizing these rare anatomical variants is paramount in achieving successful obliteration and improved functional outcome for patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- AVF:
-
Arteriovenous fistula
- CT:
-
Computed tomography
- AVM:
-
Arteriovenous malformation
- ASA:
-
Anterior spinal artery
- MRI:
-
Magnetic resonance imaging
- ABF:
-
American British French
References
Bakker NA, Uyttenboogaart M, Luijckx GJ, Eshghi OS, Mazuri A, Metzemaekers JD, Groen RJ, Van Dijk JM (2015) Recurrence rates after surgical or endovascular treatment of spinal dural arteriovenous fistulas: a meta-analysis. Neurosurgery 77(1):137–144
Bulsara KR, Hebert R, Gimbel D, Abbed K (2013) Type I spinal arteriovenous fistulae exception: a case for reclassification. Neurochirurgie 59:69–74
Chibbaro S, Gory B, Marsella M et al (2015) Surgical management of spinal dural arteriovenous fistulas. J Clin Neurosci. https://doi.org/10.1016/j.jocn.2014.07.024
Flores BC, Klinger DR, White JA, Batjer HH (2017) Spinal vascular malformations: treatment strategies and outcome. Neurosurg Rev 40:15–28
Kim LJ, Spetzler RF (2006) Classification and surgical management of spinal arteriovenous lesions: arteriovenous fistulae and arteriovenous malformations. Neurosurgery 59:S195–S201
Martin NA, Khanna RK, Batzdorf U (1995) Posterolateral cervical or thoracic approach with spinal cord rotation for vascular malformations or tumors of the ventrolateral spinal cord. J Neurosurg 83(2):254–261
Medel R, Crowley RW, Dumont AS (2009) Endovascular management of spinal vascular malformations: history and literature review. Neurosurg Focus. https://doi.org/10.3171/FOC.2009.26.1.E7
Ropper AE, Gross BA, Du R (2012) Surgical treatment of type I spinal dural arteriovenous fistulas. Neurosurg Focus. https://doi.org/10.3171/2012.1.FOCUS11344
Watson JC, Oldfield EH (1999) The surgical management of spinal dural vascular malformations. Neurosurg Clin N Am 10(1):73–87
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This case was reported in the April 2013 issue of Neurochirurgie and a reclassification system was proposed to subdivide type I into dorsal and ventral extramedullary lesions [1].
This article is part of the Topical Collection on Vascular Neurosurgery - Arteriovenous malformation
Electronic supplementary material
ESM 1
Microsurgical disconnection of intradural arteriovenous fistula with ventral venous drainage (MP4 229594 kb)
Rights and permissions
About this article
Cite this article
Lee, S., Choi, D.B. & Bulsara, K.R. Cervical spinal arteriovenous fistula with ventral perimedullary venous drainage. Acta Neurochir 162, 961–965 (2020). https://doi.org/10.1007/s00701-019-04116-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-019-04116-8