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Japanese

Multiple Spinal Arteriovenous Fistulas Occurring at Conus Medullaris and Dura of the Sacral Region : A Case Report Hideyuki AKIYAMA 1 , Shigenori KATAYAMA 2 , Koji TANAKA 3 , Kazuyoshi KOROSUE 1 1Department of Neurosurgery, Sanda Municipal Hospital 2Department of Neurosurgery, Nishi-Kobe Medical Center 3Department of Radiology, Sanda Municipal Hospital Keyword: multiple arteriovenous fistulas , spine , internal iliac artery , embolization , NBCA pp.1177-1181
Published Date 2001/12/10
DOI https://doi.org/10.11477/mf.1436902137
  • Abstract
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Multiple arteriovenous fistulas (AVFs) of the spine are rare. The authors reported a case of spinalAVFs occurring at two separate sites including the conus medullaris and the dura of the sacral region.

A 31-year-old man had a two-week history of progressive low back pain, mild gait disturbance anddysuria. Examination revealed mild motor weekness of both legs, disturbance of superficial sensibility be-low the L4 dermatome on both sides and dysuria. Sensory disturbance was most obvious in the perianal re-gion, although deep sensibility was not disturbed. Magnetic resonance images (MRIs) of the spine showedmany serpentine flow void signals from the lower thoracic region to the sacral region, and spinal arteriove-nous malformations were suspected. Selective spinal angiography revealed two AVFs at the separate sitesincluding intradural perimedullary AVF at the conus medullaris and dural AVF at the sacral region. Thedural AVF of the sacral region was fed by the left lateral sacral artery and drained through the dilated corona' venous plexus to Th 11 level.

Embolization with N-butylcyanoacrylate (NBCA) was performed using an endovascular procedure forboth AVFs. Although recanalization of the dural AVF of the sacral region was confirmed by angiographytwo weeks later, it was treated successfully by the surgical approach.


Copyright © 2001, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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