title: [Description of a series of hospital patients with a spinal fistula].
abstract: BACKGROUND
  Although spinal fistulas account for 70% of all spinal arteriovenous malformations, they are an underdiagnosed condition. The arteriovenous shunt produces vascular congestion that gives rise to a progressive myelopathy, sometimes irreversible if it is not treated in the early stages.
  
  
  OBJECTIVE
  To describe the clinicoradiological characteristics of a series of patients with spinal fistulas.
  
  
  METHODS
  A retrospective search was conducted for patients diagnosed with a spinal fistula who were hospitalised in the neuroscience area of a tertiary care hospital.
  
  
  RESULTS
  A total of 19 patients (7 females and 12 males) were identified, with a mean age of 56 years. The spinal fistula was type I in 79% of patients, and a dorsal location was the most frequent. Most of the cases (90%) presented a progressive course. Magnetic resonance imaging was used in the diagnosis in 74% of the patients. In four cases angiography was required to reach a diagnosis, and in one of them it was necessary to perform an intraoperative biopsy. Three lumbar punctures were performed, two of which revealed lymphocytic pleocytosis and high protein levels in cerebrospinal fluid. The average diagnostic delay was nine months. Seventy-nine per cent of the patients were treated and only 10% of them improved.
  
  
  CONCLUSIONS
  When faced with a clinical picture suggestive of a spinal fistula, a diagnostic spinal angiography must be carried out, although the patient under study may present atypical cerebrospinal fluid characteristics and normal results in magnetic resonance imaging of the spinal cord.
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, Espana.
authors.forename: C
authors.initials: C
authors.lastname: Garcia-Cabo
authors.affiliation: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.
authors.forename: E S
authors.initials: ES
authors.lastname: Morales-Deza
authors.affiliation: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.
authors.forename: L
authors.initials: L
authors.lastname: Martinez-Rodriguez
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, Espana.
authors.forename: E
authors.initials: E
authors.lastname: Murias-Quintana
authors.affiliation: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.
authors.forename: A
authors.initials: A
authors.lastname: Perez-Alvarez
authors.affiliation: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.
authors.forename: J
authors.initials: J
authors.lastname: Martinez-Ramos
authors.affiliation: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.
authors.forename: P
authors.initials: P
authors.lastname: Vega-Valdes
authors.affiliation: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.
authors.forename: P
authors.initials: P
authors.lastname: Suarez-Santos
authors.affiliation: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.
authors.forename: A
authors.initials: A
authors.lastname: Garcia-Rua
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, Espana.
authors.forename: G
authors.initials: G
authors.lastname: Moris
mesh_terms: D001164:Arteriovenous Fistula / Q000473:pathology*; D020785:Central Nervous System Vascular Malformations / Q000473:pathology*; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013116:Spinal Cord / Q000473:pathology*