Commentary: Spinal Arteriovenous Fistula: 2-Dimensional Operative Video

A filum terminale arteriovenous fistula (FTAVF) is an extremely rare spinal arteriovenous fistula (AVF) and typically presents with myelopathy and conus medullaris syndrome caused by venous congestion in the spinal cord. Most reported FTAVFs are intradural pial AVFs with perimedullary drainage in the filum terminale interna. However, there are no reports of AVFs in the filum terminale externa (FTE). We describe a case involving a 68-year-old man with an AVF in the FTE who presented with progressive myelopathy and underwent successful endovascular treatment. We identified the specific shunt point by fusing postoperative computed tomography and magnetic resonance images. The features of the extradural sac AVF developed in the FTE may mimic those of a dural AVF with dural supply to the FTE covered by the dural component, unlike typical FTAVFs where the shunt develops at the pia mater. This case makes a significant contribution to the field by increasing the understanding of the clinical characteristics of an AVF that develops in the FTE and its angioarchitecture.

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Sacral Extradural Angiolipoma Associated with Tight Filum Terminale and Spina Bifida Coexisting with Spinal Arteriovenous Fistula

World Neurosurgery ◽

10.1016/j.wneu.2020.04.239 ◽

2020 ◽

Vol 140 ◽

pp. 37-45

Author(s):

Prasert Iampreechakul ◽

Teera Tangviriyapaiboon ◽

Anusak Liengudom ◽

Punjama Lertbutsayanukul ◽

Samasuk Thammachantha ◽

...

Keyword(s):

Spina Bifida ◽

Arteriovenous Fistula ◽

Filum Terminale ◽

Spinal Arteriovenous Fistula ◽

Tight Filum Terminale

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Hematomyelia Caused by Ruptured Intramedullary Spinal Artery Aneurysm Associated With Extramedullary Spinal Arteriovenous Fistula-Case Report-

Neurologia medico-chirurgica ◽

10.2176/nmc.47.233 ◽

2007 ◽

Vol 47 (5) ◽

pp. 233-236 ◽

Cited By ~ 9

Author(s):

Toru MATSUI ◽

Tamiki TANIGUCHI ◽

Tatsuya SAITOH ◽

Koji KAMIJOH ◽

Takumi NAKAMURA ◽

...

Keyword(s):

Case Report ◽

Arteriovenous Fistula ◽

Artery Aneurysm ◽

Spinal Arteriovenous Fistula

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Endovascular treatment of spinal arteriovenous fistula in a young child with hereditary hemorrhagic telangiectasia

Journal of Neurosurgery Pediatrics ◽

10.3171/ped.2005.103.5.0462 ◽

2005 ◽

Vol 103 (5) ◽

pp. 462-465 ◽

Cited By ~ 1

Author(s):

Mark J. Stephan ◽

Gary M. Nesbit ◽

Melinda L. Behrens ◽

Malcolm A. Whitaker ◽

Stanley L. Barnwell ◽

...

Keyword(s):

Young Child ◽

Endovascular Treatment ◽

Arteriovenous Fistula ◽

Hereditary Hemorrhagic Telangiectasia ◽

Spinal Arteriovenous Fistula

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Intraoperative microvascular Doppler monitoring of blood flow within a spinal dural arteriovenous fistula: a precious surgical tool

Neurosurgical FOCUS ◽

10.3171/foc.2001.10.2.6 ◽

2001 ◽

Vol 10 (2) ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Domenico Gerardo Iacopino ◽

Maria Giusa ◽

Alfredo Conti ◽

Salvatore Cardali ◽

Francesco Tomasello

Keyword(s):

Flow Velocity ◽

Arteriovenous Fistula ◽

Clinical Results ◽

Spinal Dural Arteriovenous Fistula ◽

Surgical Closure ◽

Spinal Arteriovenous Fistula ◽

Surgical Tool ◽

Reliable Monitoring ◽

Velocity Changes ◽

Monitoring Modality

The authors describe a case of spinal arteriovenous fistula (AVF) treated by a microvauscular Doppler–assisted surgical interruption of the arterialized vein. Microvascular Doppler monitoring represents a valid, widely available, non-invasive tool that enables identification, through flow spectrum analysis, of components of this type of vascular malformation. In this case because the location of the fistula was identified prior to opening the dura only minimally invasive surgery was required. Direct recordings of the arterialized draining vein and the nidus of the fistula demonstrated a pathological spectrum caused by the arterial supply and the disturbed venous outflow in which a high-resistance flow pattern and low diastolic flow resembling an arterial-like flow velocity were observed. The fistula was obliterated by interruption of the draining vein, and Doppler measurements provided information on flow velocity changes in the medullary veins from an arterial to a venous pattern. The absence of any residual flow in the AVF confirmed successful hemodynamic treatment. Intraoperative microvascular Doppler recording during surgical closure of spinal AVF is a widely available and reliable monitoring modality that helps to produce excellent clinical results.

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Usefulness of color doppler ultrasound in the management of a spinal arteriovenous fistula

Surgical Neurology ◽

10.1016/s0090-3019(01)00571-7 ◽

2001 ◽

Vol 56 (5) ◽

pp. 304-307 ◽

Cited By ~ 6

Author(s):

Francesca Tekula ◽

Michael B. Pritz ◽

Kenyon Kopecky ◽

Steven J. Willing

Keyword(s):

Arteriovenous Fistula ◽

Doppler Ultrasound ◽

Color Doppler ◽

Color Doppler Ultrasound ◽

Spinal Arteriovenous Fistula

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Clipping of spinal arteriovenous fistula of the filum terminale under intraoperative angiography guidance

Formosan Journal of Surgery ◽

10.4103/fjs.fjs_36_19 ◽

2019 ◽

Vol 52 (4) ◽

pp. 151 ◽

Cited By ~ 1

Author(s):

Hsin-Yao Lin ◽

Yun-Ju Lee ◽

Kai-Chun Lin ◽

Cheng-Chia Tsai

Keyword(s):

Arteriovenous Fistula ◽

Filum Terminale ◽

Intraoperative Angiography ◽

Spinal Arteriovenous Fistula

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Spinal arteriovenous fistula

10.53347/rid-70004 ◽

2019 ◽

Author(s):

Francis Deng ◽

Johan Smalberger

Keyword(s):

Arteriovenous Fistula ◽

Spinal Arteriovenous Fistula

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Spinal Arteriovenous Fistula, A Manifestation of Hereditary Hemorrhagic Telangiectasia: A Case Report

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2020.5.47086 ◽

2020 ◽

Vol 4 (3) ◽

pp. 417-420

Author(s):

Jodi Spangler ◽

Bjorn Watsjold ◽

Jonathan Ilgen

Keyword(s):

Case Report ◽

Arteriovenous Fistula ◽

Hereditary Hemorrhagic Telangiectasia ◽

Early Recognition ◽

Endovascular Embolization ◽

High Morbidity ◽

Autosomal Dominant Disorder ◽

Arteriovenous Fistulas ◽

Spinal Arteriovenous Fistula ◽

The Right

Introduction: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by arteriovenous malformations (AVM). HHT can have neurological manifestations. Case Report: A 32-year-old woman with a history of HHT presented to the emergency department with acute partial paralysis of the right leg, urinary retention, and right-sided back and hip pain. Magnetic resonance imaging of the spine demonstrated multiple, dilated blood vessels along the cervical spine, diffuse AVMs in the lumbar and thoracic spine, and a new arteriovenous fistula at the twelfth thoracic (T12) vertebral level. Her symptoms improved after endovascular embolization of the fistula. Conclusion: Spinal AVMs are thought to be more prevalent in patients with HHT. Given the high morbidity of arteriovenous fistulas, early recognition and intervention are critical.

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