title: Radiculo-pial spinal arteriovenous fistulas treated with coils: Report of two cases.
abstract: Spinal pial arteriovenous fistulas (SPAVFs) are rare lesions that present more frequently in young patients. Lesions located on radiculo-pial arteries without involvement of the anterior spinal artery are even rarer. SPAVFs may present with mass effect, venous congestion or hemorrhage. Most often, treatment is performed either by surgery or endovascularly with fluid embolic material. Use of microcoils has not been reported for this condition.We present two cases of radiculo-pial high-flow SPAVFs in two patients in their early 30 s. One patient presented with abrupt headache without proof of hemorrhage and the other one with trigeminal neuralgia resulting from dilated posterior fossa draining veins remote from the fistula. Both patients were successfully treated with endovascular shunt closure using microcoils with resolution of symptoms and disappearance of the dilated veins at follow-up.With recent advances in microcatheter technology, distal navigation and microcoil embolization offers another option for these cases that may be safer than fluid embolic material.
authors.affiliation: Centre hospitalier de l'Université de Montréal (CHUM) Notre-Dame Hospital, Canada.
authors.forename: André Lima
authors.initials: AL
authors.lastname: Batista
authors.affiliation: Centre hospitalier de l'Université de Montréal (CHUM) Notre-Dame Hospital, Canada.
authors.forename: Diego Gutierrez
authors.initials: DG
authors.lastname: Romero
authors.affiliation: Centre hospitalier de l'Université de Montréal (CHUM) Notre-Dame Hospital, Canada.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Gentric
authors.affiliation: Centre hospitalier de l'Université de Montréal (CHUM) Notre-Dame Hospital, Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Weill
authors.affiliation: Centre hospitalier de l'Université de Montréal (CHUM) Notre-Dame Hospital, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Raymond
authors.affiliation: Centre hospitalier de l'Université de Montréal (CHUM) Notre-Dame Hospital, Canada daniel.roy.chum@ssss.gouv.qc.ca.
authors.forename: Daniel
authors.initials: D
authors.lastname: Roy
mesh_terms: D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D001164:Arteriovenous Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002404:Catheterization; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D003388:Cranial Fossa, Posterior / Q000601:surgery; D004621:Embolization, Therapeutic / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008297:Male; D013122:Spinal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013131:Spine / Q000098:blood supply / Q000000981:diagnostic imaging; D015607:Stents; D014277:Trigeminal Neuralgia / Q000209:etiology / Q000601:surgery
keywords: Embolization; spinal AV fistulas; spinal AVMs