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Japanese

A Case of Spinal Dural Arteriovenous Fistula Draining to the Ventral Coronal Venous Plexus Masanori Yoshino 1 , Michihiro Kohno 2 , Seisaku Kanayama 1 , Hiroto Yazaki 1 , Hiromu Segawa 1 , Isamu Saito 1 , Keiji Sano 1 1Department of Neurosurgery, Fuji Brain Institute and Hospital 2Department of Neurosurgery, Tokyo Metropolitan Police Hospital Keyword: spinal dural arteriovenous fistula , anterior spinal vein pp.617-621
Published Date 2005/7/1
DOI https://doi.org/10.11477/mf.1406100059
  • Abstract
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Here we report a case of spinal dural areteriovenous fistula (AVF) draining to the anterior spinal vein. An 80-year-old female presented with progressive weakness of lower extremities. MRI showed spinal enlargement at the Th10 to L1 with high intensity signals on T2-weighted image and multiple flow voids on the dorsal and ventral surface of the spinal cord. Angiogram of the left L2 lumbar artery demonstrated a hairpin-shaped vessel with ascending and descending limbs, mimicking radiculomedullary artery. Oblique view angiogram of the left L2 lumbar artery showed that radiculomedullary vein drained to the dilated anterior spinal vein, which then drained cranially and caudally on the anterior and posterior surface of the spinal cord. The patient underwent T9~L2 laminectomy. Several large tortuous dilated veins in the subarachnoid space were found. Examination of the inner surface of the dura revealed a arterialized vein that began at the level of L2 and coursed superioly. The arterialized vein was coagulated and interrupted. The postoperative angiogram demonstrated the obliteration of the fistula. Postoperative MRI returned to normal with complete disappearance of T2 high signal, cord enlargement.

 In most spinal dural AVF, the venous drainage is predominantly upward on the posterior surface of the spinal cord. The spinal dural AVF draining to the anterior spinal vein is atypical, and cause difficulty in differentiating the anterior spinal artery from the anterior spinal vein. Oblique view angiogram may be helpful to differentiate the anterior spinal vein from anterior spinal artery.

(Received : April 20, 2005)


Copyright © 2005, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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