Secondary clinical deterioration after successful embolization of a spinal dural arteriovenous fistula: a plea for prophylactic anticoagulation.
We present a case of delayed aggravation of initially-resolved symptoms in a patient after successful embolization of a T5 spinal dural arteriovenous (AV) fistula with N-butyl cyanoacrylate. The symptoms were attributed to venous thrombosis and resolved with systemic anticoagulation after five days of treatment. Although the most adequate treatment for preventing venous thrombosis after spinal dural AV fistula is not known, we describe this patient as a case for more aggressive prophylactic anticoagulation measures in the immediate post-embolization time period.
Knopman
J
J
Department of Neurosurgery, Weill Medical College of Cornell University, New York, NY, USA. jak9030@nyp.org
Zink
W
W
Patsalides
A
A
Riina
H A
HA
Gobin
Y P
YP
D000792:Angiography; D000925:Anticoagulants / Q000627:therapeutic use*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000517:prevention & control*
D000925:Anticoagulants; D004659:Enbucrilate