title: Spinal epidural arteriovenous fistula: a unique pathway into the perimedullary vein. A case report.
abstract: Spinal dural arteriovenous fistulas (AVFs) are rare vascular malformations in the spinal dura, fed by dural branches of the radicular arteries, and drain primarily into intradural venous plexuses. They may cause elevated medullary venous pressure and produce a progressive myelopathy. We describe a case of AVF in the epidural space of the previous surgery site of L3 and it showed a unique complex venous pathway into the perimedullary vein, leading to classic clinical symptoms of venous congestion in the spinal cord. The shunt was draining into bilateral epidural venous plexus and then to the paravertebral veins at the level of L2. The venous outflow entered to the epidural space again and finally refluxed into the intradural perimedullary vein.
authors.affiliation: Lahey Clinic Medical Center; Burlington, MA, USA - in.sup.choi@lahey.org.
authors.forename: S M
authors.initials: SM
authors.lastname: Lim
authors.forename: I S
authors.initials: IS
authors.lastname: Choi
references.citation: J Neurosurg. 1967 Mar;26(3):346-51
references.pmid: 6019742
references.citation: Acta Neurochir (Wien). 2002 May;144(5):493-6
references.pmid: 12111506
references.citation: Neurosurgery. 2001 Jun;48(6):1372-5; discussion 1375-6
references.pmid: 11383745
references.citation: Neuroradiology. 1994 Aug;36(6):490-1
references.pmid: 7991100
references.citation: J Neurosurg. 2002 Mar;96(2 Suppl):145-56
references.pmid: 12450276
references.citation: J Neurosurg Spine. 2006 Oct;5(4):353-8
references.pmid: 17048773
references.citation: Stroke. 2008 Oct;39(10):2783-94
references.pmid: 18635840
references.citation: Eur J Radiol. 2003 Jun;46(3):221-32
references.pmid: 12758116
references.citation: Neuroradiology. 1977 Sep 30;14(2):97-100
references.pmid: 909634
references.citation: Neurosurgery. 1997 Apr;40(4):675-82; discussion 682-3
references.pmid: 9092840
references.citation: J Neurosurg Spine. 2007 Jun;6(6):552-8
references.pmid: 17561744
references.citation: Radiology. 1982 Jul;144(1):103-7
references.pmid: 6806851
references.citation: Neuroradiology. 1990;31(6):529-32
references.pmid: 2112735
references.citation: AJNR Am J Neuroradiol. 1993 Jul-Aug;14(4):812-7
references.pmid: 8352150
references.citation: Clin Neurosurg. 1988;34:161-83
references.pmid: 3288393