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KMID : 1148020210460020062
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조선대학교의대논문집
2021 Volume.46 No. 2 p.62 ~ p.67
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Perimedullary AVF with remarkably epidural reflux which was considered to be accompanied with epidural AVF preoperatively
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Ju Chang-Il
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Abstract
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Purpose: An exact understanding of spinal perimedullary arteriovenous fistula anatomy is essential to obliterate fistulous point safely. In this study we discuss the surgical posterior approach to the ventrally located AVF and pathological characteristics of perimedullary and dural spinal arteriovenous fistula. Material and Method: We report a case of perimedullary arteriovenous fistula with remarkable epidural reflux, showing a 20-month history of progressive both legs’ weakness and numbness were presented. Results: A 65-year-old man with a rare case of perimedullary arteriovenous fistula with remarkable epidural reflux, Magnetic Resonance imaging revealed ventrally located serpentine flow void area at the C2-4 levels on T2-weighted image. Digital subtraction angiography (DSA) images demonstrated multiple epidural shunt of fistula fed from left C2, 3, 5 segmental arteries and a perimedullary arteriovenous fistulous shunt fed from right C4 radiculo-medullary artery and drained into an ascending perimedullary vein. Surgical interruption was performed by postero-lateral approach with rotating spinal cord to expose the ventrally located epidural as well as perimedullary AV fistulous shunts. Postoperative spinal angiography revealed no evidence of residual fistulous shunt. Conclusions: This study constitutes the first report of the surgical posterior approach to the ventrally located AVF and pathological characteristics of perimedullary and dural spinal arteriovenous fistula.
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KEYWORD
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Epidural reflux, Hemilaminectomy, Perimedullary arteriovenous fistula
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Listed journal information
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