title: [Sacral dural arteriovenous fistula: report of 4 cases].
abstract: Spinal dural arteriovenous fistula (SDAVF) in the sacral region is relatively rare and remains difficult to diagnose because of the uncommon origin of its feeder. It also has higher incidence of recurrence than usual thoraco-lumbar lesion and needs subsequent treatment. We reviewed 51 cases of SDAVF over the past 10 years. Especially in patients with sacral lesion, clinical features and the findings on spinal angiography were analyzed. Four patients (7.8%) had SDAVF in the sacral region. In all cases, SDAVF were supplied by the lateral sacral artery. Multiple feeders were observed in 3 (75%) out of 4 patients and 2 patients (50%) had multiple fistulas. Endovascular embolizations were performed in all patients, and neurological symptoms were improved in two patients (50%) and the other two were stabilized (50%). There was no recurrence during a follow-up period of 3 months to 8 years. We should keep in mind that SDAVF in the sacral region can have multiple shunts and feeders derived from the lateral sacral artery.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Sasamori
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Hida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Asano
authors.forename: Takeshi
authors.initials: T
authors.lastname: Aoyama
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yamauchi
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yano
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
mesh_terms: D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012447:Sacrum / Q000098:blood supply