gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Spinal dural arteriovenous fistulae: a consecutive series of 6 patients

Meeting Abstract

  • G. Koerts - Neurosurgery Service, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
  • H. Rooijakkers - Neurosurgery Service, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
  • V. Vanthuyne - Neurosurgery Service, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
  • M. Delavalée - Neurosurgery Service, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
  • C. Raftopoulos - Neurosurgery Service, Cliniques universitaires Saint-Luc, Bruxelles, Belgique

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocDI.06-07

DOI: 10.3205/09dgnc150, URN: urn:nbn:de:0183-09dgnc1503

Published: May 20, 2009

© 2009 Koerts et al.
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Outline

Text

Objective: Spinal dural arteriovenous fistulae (SDAVF) are rare lesions in which an abnormal vascular shunt exists between a dural branch of a segmental spinal artery and a radicular vein that drains the perimedullary venous system. Optimal treatment of these lesions by surgery or embolization is still a matter of debate. We present the clinical characteristics of six consecutive patients and will discuss the treatment options in the light of the current literature.

Methods: We retrospectively reviewed the medical charts of 6 consecutive patients diagnosed with a spinal dural arteriovenous fistula between 2002 and 2007. Clinical history, time to diagnosis, neurologic examination and imaging results were retrospectively collected.

Results: There were 4 male and 2 female patients with a mean age of 55 years. The mean time to diagnosis was 9 months. Mean follow-up was 28 months. Progressive paraparesis, sensory deficits and gait ataxia were present in 5 of 6 patients. Urinary incontinence was present in 5 patients at diagnosis. The mean Aminoff-Logue score pre- and postoperatively were 5,5 and 4,3 respectively. All patients were treated by embolization and/or surgery. Two patients had embolization as the primary treatment option. Four patients were primarily operated. Complete obliteration was obtained in all treated patients. Two patients required a second procedure. All six patients were stable or better after endovascular or surgical treatment.

Conclusions: SDAVF will lead to significant morbidity if left untreated. If complete obliteration of the fistula cannot be achieved by embolization, direct surgery is recommended to avoid deterioration.