Spinal dural arteriovenous fistula (DAVF): management
Evidence-based neurology checklist on spinal dural arteriovenous fistula (davf): management: Magnetic resonance imaging (MRI) Spinal cord swelling Central hyperintense T2 signal over 5-7 segments Hypointense tortuous flow voids: these are dorsal to the spinal cord Contrast enhancement of spinal…
Magnetic resonance imaging (MRI)
- Spinal cord swelling
- Central hyperintense T2 signal over 5-7 segments
- Hypointense tortuous flow voids: these are dorsal to the spinal cord
- Contrast enhancement of spinal cord: this shows as the missing piece sign
- Serpentine peri-medullary structures: these are seen on magnetic resonance angiogram (MRA)
Spinal catheter angiography
Endovascular embolization therapy
Microsurgical occlusion
Precaution
References
- Jellema K, Tijssen CC, van Gijn J. Spinal dural arteriovenous fistulas: a congestive myelopathy that initially mimics a peripheral nerve disorder. Brain 2006; 129:3150-3164.
- Toossi S, Josephson SA, Hetts SW, et al. Utility of MRI in spinal arteriovenous fistula. Neurology 2012; 79:25-30.
- Zalewski NL, Rabinstein AA, Brinjikji W, et al. Unique gadolinium enhancement pattern in spinal dural arteriovenous fistulas. JAMA Neurol 2018; 75:1542-1545.
- Koch MJ, Stapleton CJ, Agarwalla PK, et al. Open and endovascular treatment of spinal dural arteriovenous fistulas: a 10-year experience. J Neurosurg Spine 2017; 26:519-523.
- Nasr DM, Brinjikji W, Rabinstein AA, Lanzino G. Clinical outcomes following corticosteroid administration in patients with delayed diagnosis of spinal arteriovenous fistulas. J Neurointerv Surg 2017; 9:607-610.
