[Spinal dural arteriovenous fistula: clinical and radiological findings in 54 patients].
OBJECTIVE
Presentation of the clinical and radiological findings in spinal dural arteriovenous fistulas (SDAVF) based on the experience in 54 patients.


METHODS
Evaluation of patients' records and myelography (n = 23), MRI (n = 54) as well as conventional angiography (n = 54) with respect to history, symptoms, clinical and radiological results.


RESULTS
Clinically, a long history (mean 20 months) with progressive ascending paresis (100 %), sensory deficits (93 %) and loss of control over bladder and bowel function (89 %) in male patients (78 %) of advanced age (mean 60 years) indicates the disease. Typical signs in MRI are central cord hyperintensity (100 %) with slight medullary distension (74 %), contrast enhancement (79 %) and distended perimedullary veins (89 %), the latter being disclosed by myelography in 78 % of cases. For diagnosis spinal angiography is necessary which most often shows a thoracic location of the fistula (69 %), more than one feeding artery (67 %) and caudal as well as rostral venous drainage (63 %).


CONCLUSIONS
MRI is superior to myelography to detect diagnostic signs of SDAVF in patients with typical clinical presentation. For definitive diagnosis spinal angiography is still indispensable.
Koch
C
C
Abteilung für Neuroradiologie, Universitätsklinikum Hamburg Eppendorf. ckoch@medinf.mu-luebeck.de
Kucinski
T
T
Eckert
B
B
Röther
J
J
Zeumer
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009192:Myelography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000098:blood supply; D013122:Spinal Diseases / Q000175:diagnosis*