title: Outcome and prognostic factors in the surgical treatment of spinal dural arteriovenous fistulas. A long-term study.
abstract: From a total of 78 patients surgically treated for a spinal dural arteriovenous fistula, in whom long-term follow-up was available, 25 have been reviewed. Their outcome at different postoperative stages and the long-term prognostic factors is discussed. Excision or coagulation of the nidus, as well as disconnection of the draining vein offers better results in the long-term than clipping of the draining vein alone. Prolonged duration of symptoms and poor functional status before surgical treatment adversely affect the long-term outcome. Age at the time of surgery did not influence outcome in this study. In the long-term all patients tended to show a moderate, but definite functional decline. This is unlikely to be due entirely to recanalization and may represent a more generalized haemodynamic abnormality of the cord together with the effects of age on the original damage.
authors.affiliation: National Hospital for Neurology and Neurosurgery, London, UK.
authors.forename: L
authors.initials: L
authors.lastname: Tacconi
authors.forename: B C
authors.initials: BC
authors.lastname: Lopez Izquierdo
authors.forename: L
authors.initials: L
authors.lastname: Symon
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001164:Arteriovenous Fistula / Q000150:complications / Q000601:surgery*; D004388:Dura Mater / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome