Cauda Equina Syndrome Caused by Spinal Dural Arteriovenous Fistula
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Spinal dural arteriovenous fistula (SDAVF) is rare but still the most commonly encountered vascular malformation of the spinal cord. A 31-year-old male developed gait disturbance due to weakness of his lower extremities,voiding diffi culty and sexual dysfunction with a progressive course since 3 months. He showed arefl exia in both knees and ankles. Electromyographic fi ndings were suggestive of multiple root lesions involving bilateral L2 to S4roots of moderate degree. Magnetic resonance images showed high signal intensity with an ill-defined margin in T2-weighted images and intensely enhanced by a contrast agent through the lumbosacral spinal cord. Selective spinal angiography confirmed a dural arteriovenous fistula with a nidus at the L2 vertebral level. After selective endovascular embolization, his symptoms drastically improved except sexual dysfunction. We report a rare case of cauda equina syndrome due to spinal arteriovenous fistula with drastic improvement after endovascular embolization.
Abstract
Spinal dural arteriovenous fistula (SDAVF) is rare but still the most commonly encountered vascular malformation of the spinal cord. A 31-year-old male developed gait disturbance due to weakness of his lower extremities,voiding diffi culty and sexual dysfunction with a progressive course since 3 months. He showed arefl exia in both knees and ankles. Electromyographic fi ndings were suggestive of multiple root lesions involving bilateral L2 to S4roots of moderate degree. Magnetic resonance images showed high signal intensity with an ill-defined margin in T2-weighted images and intensely enhanced by a contrast agent through the lumbosacral spinal cord. Selective spinal angiography confirmed a dural arteriovenous fistula with a nidus at the L2 vertebral level. After selective endovascular embolization, his symptoms drastically improved except sexual dysfunction. We report a rare case of cauda equina syndrome due to spinal arteriovenous fistula with drastic improvement after endovascular embolization.
참고문헌 (10)
- Kendall BE, "Spinal epidural angiomatous malformations draining into intrathecal veins", Neuroradiology, 13, pp.181~189 (1977)
- Krings T, "Spinal dural arteriovenous fi stulas", Am J Neuroradiol, 30, pp.639~648 (2009)
- Jellema K, "Spinal dural arteriovenous fistulas: clinical features in 80 patients", J Neurol Neurosurg Psychiatry, 74, pp.1438~1440 (2003)
- Koch C, "Spinal dural arteriovenous fi stula", Curr Opin Neurol, 19, pp.69~75 (2006)
- Foix C, "Subacute necrotic myelitis, slowly progressive central myelitis with vacular hyper plasia, and slowly ascending, increasingly flaccid amyotrophic paraplegia accompanied by albuminocytologic dissociation", Rev Neurol, 33, pp.1~42 (1926)
- Schick U, "Treatment and outcome of spinal dural arteriovenous fi stulas", Eur Spine J, 12, pp.350~355 (2003)
- Sung Bae Park, "Spinal Dural Arteriovenous Fistulas : Clinical Experience with Endovascular Treatment as a Primary Therapeutic Modality", 대한신경외과학회지, 44(6), pp.364~369 (2008), 대한신경외과학회
- Prieto R, "Recovery from paraplegia after the treatment of spinal dural arteriovenous fistula: case report and review of the literature", Acta Neurochir, 151, pp.1385~1397 (2009)
- Hassler W, "Hemodynamics of spinal dural arteriovenous fi stulas. An intraoperative study", J Neruosurg, 70, pp.360~370 (1989)
- Andres RH, "Endovascular and surgical treatment of spinal dural arteriovenous fi stulas", Neruoradiology, 50, pp.869~876 (2008)