scholarly journals Fracture and migration of a retained microcatheter into the cauda equina after endovascular neurointervention for dural arteriovenous fistula as a rare cause of tethered spinal cord: case report

2020 ◽  
Vol 32 (4) ◽  
pp. 607-610
Author(s):  
Gulden Demirci Otluoglu ◽  
Teyyub Hasanov ◽  
Basak Mert ◽  
Zafer Orkun Toktas ◽  
Deniz Konya ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Vascular Malformations ◽  
Cauda Equina ◽  
Definitive Treatment ◽  
Spinal Cord Infarction ◽  
Tethered Spinal Cord ◽  
And Migration

The evaluation of spinal cord vascular malformations in neuroradiology departments remains valid for both diagnosis and endovascular embolization, and for adjuvant as well as definitive treatment. The most commonly encountered complications of endovascular approaches are the recurrence or the incomplete embolization of the lesion and accidental damage to the medullary arteries, which leads to spinal cord infarction. Failure to remember a microcatheter in the abdominal aorta after catheterization is an underestimated complication. A retained guidewire in the circulation may not necessarily cause symptoms, and it may remain unnoticed for a significant period of time. However, severe complications may be faced even many years later. In this article, a case report on a fracture and migration of a retained microcatheter in the cauda equina is presented. This occurred after an endovascular neurointervention for dural arteriovenous fistula as a rare cause of tethered spinal cord.

scholarly journals Paraplegia after contrast media application: a transient or devastating rare complication? Case report

2016 ◽  
Vol 24 (5) ◽  
pp. 806-809 ◽  
Author(s):  
Dorothee Mielke ◽  
Kai Kallenberg ◽  
Marius Hartmann ◽  
Veit Rohde
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Contrast Media ◽  
Arteriovenous Fistula ◽  
Digital Subtraction Angiography ◽  
Dural Arteriovenous Fistula ◽  
Rare Complication ◽  
Digital Subtraction ◽  
Spinal Dural Arteriovenous Fistula ◽  
The Individual

The authors report the case of a 76-year-old man with a spinal dural arteriovenous fistula. The patient suffered from sudden repeated reversible paraplegia after spinal digital subtraction angiography as well as CT angiography. Neurotoxicity of contrast media (CM) is the most probable cause for this repeated short-lasting paraplegia. Intolerance to toxicity of CM to the vulnerable spinal cord is rare, and probably depends on the individual patient. This phenomenon is transient and can occur after both intraarterial and intravenous CM application.

Spinal dural arteriovenous fistula associated with a spinal perimedullary fistula

2006 ◽  
Vol 4 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Timo Krings ◽  
Volker A. Coenen ◽  
Martin Weinzierl ◽  
Marcus H. T. Reinges ◽  
Michael Mull ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Vascular Malformations ◽  
Venous Drainage ◽  
Elevated Pressure ◽  
Spinal Dural Arteriovenous Fistula ◽  
Arteriovenous Fistulas ◽  
Progressive Myelopathy ◽  
Dural Arteriovenous Fistulas

✓ Among spinal cord vascular malformations, dural arteriovenous fistulas (DAVFs) must be distinguished from intradural malformations. The concurrence of both is extremely rare. The authors report the case of a 35-year-old man who suffered from progressive myelopathy and who harbored both a DAVF and an intradural perimedullary fistula. During surgery, both fistulas were identified, confirmed, and subsequently obliterated. The fistulas were located at two levels directly adjacent to each other. Although the incidence of concurrent spinal DAVFs is presumed to be approximately 2%, the combination of a dural and an intradural fistula is exceedingly rare; only two other cases have been reported in the literature. One can speculate whether the alteration in venous drainage caused by the (presumably congenital) perimedullary fistula could possibly promote the production of a second dural fistula due to elevated pressure with concomitant venous stagnation and subsequent thrombosis. The authors conclude that despite the rarity of dual pathological entities, the clinician should be aware of the possibility of the concurrence of more than one spinal fistula in the same patient.

Dural Arteriovenous Fistula at the Craniocervical Junction Mimicking Acute Brainstem and Spinal Cord Infarction

2013 ◽  
Vol 70 (6) ◽  
pp. 796 ◽  
Author(s):  
Elliott Salamon ◽  
Athos Patsalides ◽  
Y. Pierre Gobin ◽  
Alejandro Santillan ◽  
Matthew E. Fink
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Craniocervical Junction ◽  
Spinal Cord Infarction

scholarly journals Cauda equina arteriovenous fistula supplied by proximal radicular artery and concomitant sacral dural arteriovenous fistula: A case report and literature review

2021 ◽  
Vol 12 ◽  
pp. 405
Author(s):  
Prasert Iampreechakul ◽  
Punjama Lertbutsayanukul ◽  
Somkiet Siriwimonmas
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Fistula ◽  
Vascular Malformations ◽  
Cauda Equina ◽  
Unknown Origin ◽  
Vascular Lesion ◽  
Conus Medullaris ◽  
Venous Hypertension ◽  
Arteriovenous Fistulas ◽  
Spinal Vascular Malformations

Background: Cauda equina arteriovenous fistulas (AVFs) fed by the proximal radicular artery are exceedingly rare. Spinal dural arteriovenous fistulas (DAVFs) in the sacral region are rare and usually misdiagnosed. We report a case of a cauda equina AVF with concomitant sacral DAVF. We also review the coexistence of multiple types of spinal vascular malformations in a single patient. Case Description: A 54-year-old man presented with progressive weakness of the lower extremities for 1 month. Magnetic resonance imaging (MRI) of the lumbosacral and thoracic spine showed spinal cord congestion, extending from the conus medullaris to the level of T7, and abnormal tortuous and dilated flow void, running from the level of L5 to T12 along anterior surface of the spinal cord. Spinal angiography demonstrated the fistula at the level of L2 below the conus medullaris. Based on intraoperative findings, the cauda equina AVF supplied by the proximal radicular artery with cranial drainage through the enlarged radicular vein was confirmed and successfully obliterated. Another enlarged arterialized radicular vein running parallel to another cauda equina nerve root is observed with unknown origin. After the operation, the patient showed mild improvement of his symptoms. Follow-up MRI and contrast-enhanced MR angiography revealed an another sacral DAVF vascularized by the lateral sacral artery. Conclusion: The coexistence of different spinal vascular malformations in a same patient is extremely rare. Most authors of several studies hypothesized that venous hypertension and thrombosis due to the presence or treatment of the first spinal vascular lesion may produce a second DAVF.

scholarly journals Spontaneous spinal cord infarction secondary to embolism from an aortic aneurysm mimicking as cauda equina due to disc prolapse: a case report

Cases Journal ◽  
2009 ◽  
Vol 2 (1) ◽  
pp. 7460 ◽  
Author(s):  
Bassel El-Osta ◽  
Ali Ghoz ◽  
Vinay Kumar Singh ◽  
Elrasheid Saed ◽  
Murad Abdunabi
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Aortic Aneurysm ◽  
Cauda Equina ◽  
Spinal Cord Infarction ◽  
Disc Prolapse

Microsurgical Management of a Spinal Dural Arteriovenous Fistula With Shared Blood Supply to the Artery of Adamkiewicz: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (6) ◽  
pp. E174-E175 ◽  
Author(s):  
C Michael Cawley ◽  
Brian M Howard ◽  
Daniel L Barrow
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Arteriovenous Fistula ◽  
Blood Supply ◽  
Dural Arteriovenous Fistula ◽  
Spinal Cord Infarction ◽  
Thoracic Myelopathy ◽  
Spinal Dural Arteriovenous Fistula ◽  
Lower Extremity Weakness ◽  
Artery Of Adamkiewicz

Abstract The presented case is of a 65-yr-old gentleman referred for thoracic myelopathy. He developed bilateral, nondermatomal foot dysesthesia 14 mo prior to presentation, which progressed to numbness below the L3 level. He reported progressive gait instability, bilateral lower extremity weakness, and required a cane for ambulation. He subsequently developed urinary incontinence, while bowel function was spared. The neurological examination upon presentation revealed lower extremity strength was reduced to 4/5 in all major muscle groups bilaterally, while sensation and proprioception were reduced below the L3 level. Patellar and Achilles reflexes were not elicited and clonus was absent. Gait was unsteady and slow. The patient was not able to perform heel, toe and tandem gait. MRI revealed abnormal T2 hyper-intense signal and spinal cord expansion from T6 through the conus medullaris. Angiography revealed a dural arteriovenous fistula (dAVF) originating from the left T9 radicomedullary pedicle, which also supplied the Artery of Adamkiewicz (AoA). The patient underwent T8-10 laminectomies. Prior to disconnection of the fistula, an aneurysm clip was applied to the fistulous point and an indocyanine green video angiogram was completed to show that the fistula no longer opacified, but that the AoA remained patent, which was later confirmed with angiography. As of discharge, the patient's motor exam had improved substantially, though his sensory deficits persisted. This case demonstrates that surgical disconnection is requisite in the treatment of spinal dAVF that have a shared blood supply with the AoA, as embolization risks spinal cord infarction.  The patient consented to presentation of this case in a de-identified fashion.

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