title: Arteriovenous fistula of the filum terminale: radiological diagnosis and therapeutic management by embolization.
abstract: A 60-year-old man had progressive paraparesis, paresthesia of both lower limbs and sphincter dysfunction. He underwent MRI, which revealed perimedullar abnormal vascular channels associated with a hypersignal in the thoracolumbar cord. Because of the patient's age and symptomatology, a dural arteriovenous shunt was first suspected. MRA confirmed dilatation of the perimedullary venous channels, but also revealed an enlarged anterior spinal artery, a finding incompatible with a diagnosis of dural arteriovenous fistula. A lesion, vascularized by the anterior spinal axis and draining secondarily into the perimedullary veins, was thus suspected. Angiography diagnosed a microfistula of the filum terminale; selective distal catheterization of the arterial feeder from T11 to S1 was achieved, and the shunt closed by embolization with acrylic glue. The patient improved after endovascular treatment.
authors.affiliation: Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital Foch, 40, rue Worth, BP 36, 92151 Suresnes, France. Samuel.haddad@yahoo.fr
authors.forename: Samuel
authors.initials: S
authors.lastname: Haddad
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Condette-Auliac
authors.forename: Augustin
authors.initials: A
authors.lastname: Ozanne
authors.forename: Luca
authors.initials: L
authors.lastname: Roccatagliata
authors.forename: Georges
authors.initials: G
authors.lastname: Rodesch
mesh_terms: D001164:Arteriovenous Fistula / Q000175:diagnosis* / Q000628:therapy*; D002420:Cauda Equina / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D004621:Embolization, Therapeutic; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome