Spinal Dural Arteriovenous Fistula: A Review.
Spinal dural arteriovenous fistula (SDAVF) is a rare disease, the etiology of which is not entirely clear. It is the most common vascular malformation of the spinal cord, comprising 60-80 % of the cases. The clinical presentation and imaging findings may be nonspecific and misleading, often mistaking it for other entities like demyelinating or degenerative diseases of the spine.This chapter describes the imaging findings, clinical signs, and symptoms of this disease and also the available treatment options according to the current literature.Angiography is still considered the gold standard for diagnosis; however, MRI/MRA is increasingly used as a screening tool. Modern endovascular techniques are becoming increasingly more effective in treating SDAVF offering a less invasive treatment option; however, they still lag behind surgical success rates which approach 100 %. The outcome of both treatment options is similar if complete obliteration of the fistula is obtained and depends mainly on the severity of neurological dysfunction before treatment.Heightened awareness by radiologists and clinicians to this rare entity is essential to make a timely diagnosis of this treatable disease. A multidisciplinary treatment approach is required in order to make appropriate treatment decisions.
Department of Neurosurgery, Sourasky Hospital Tel Aviv Medical Center, Tel Aviv, Israel. shimonm@tlvmc.gov.il.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. shimonm@tlvmc.gov.il.
Shimon
S
Maimon
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Neuroradiology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
Yehudit
Y
Luckman
Department of Neurosurgery, Sourasky Hospital Tel Aviv Medical Center, Tel Aviv, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ido
I
Strauss
D000792:Angiography; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis* / Q000628:therapy*; D004388:Dura Mater / Q000098:blood supply; D008279:Magnetic Resonance Imaging; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000628:therapy*
Medullary artery; Radicular artery; Radicular vein; SDAVF; Spinal angiography; Spinal cord edema; Spinal dural arteriovenous fistula; Spinal venous congestion