title: Spinal dural arteriovenous fistulas: outcome and prognostic factors.
abstract: The aim of this study is to review the clinical outcome of patients treated for spinal dural arteriovenous malformations and investigate the presence of pretreatment indicators of outcome after short- and midterm follow-up. The authors retrospectively reviewed the records of 65 consecutive patients treated either surgically or endovascularly in 3 neurosurgery departments between 1989 and 2009. After treatment, 80% of patients reported improvement of at least 1 symptom. Motor symptoms improved more than sensory disorders, pain, or sphincter impairment. Spinal dural arteriovenous fistulas at the thoracic level, and in particular at the lower level, responded better than those in other spinal areas. Spinal dural arteriovenous fistula is a rare pathology with a malignant course that should be treated aggressively. This study appears to confirm that neurological status before treatment, anatomical location of the fistula, and symptoms at presentation are all factors that can predict outcome. Early diagnosis of spinal dural arteriovenous malformations in the lower thoracic area in patients with an Aminoff scale score < 3 was associated with the most favorable outcome.
authors.affiliation: Department of Neurosurgery, Niguarda Cà Granda Hospital, Milan, Italy. marco.cenzato@ospedaleniguarda.it
authors.forename: Marco
authors.initials: M
authors.lastname: Cenzato
authors.forename: Alberto
authors.initials: A
authors.lastname: Debernardi
authors.forename: Roberto
authors.initials: R
authors.lastname: Stefini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Aliberti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Piparo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Talamonti
authors.forename: Matteo
authors.initials: M
authors.lastname: Coppini
authors.forename: Pietro
authors.initials: P
authors.lastname: Versari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery / Q000379:methods*; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult