Document Detail


Clinical presentation and prognostic factors of spinal dural arteriovenous fistulas: an overview.
MedLine Citation:
PMID:  22537126     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Spinal dural arteriovenous fistulas (AVFs), the most common type of spinal cord vascular malformation, can be a challenge to diagnose and treat promptly. The disorder is rare, and the presenting clinical symptoms and signs are nonspecific and insidious at onset. Spinal dural AVFs preferentially affect middle-aged men, and patients most commonly present with gait abnormality or lower-extremity weakness and sensory disturbances. Symptoms gradually progress or decline in a stepwise manner and are commonly associated with pain and sphincter disturbances. Surgical or endovascular disconnection of the fistula has a high success rate with a low rate of morbidity. Motor symptoms are most likely to improve after treatment, followed by sensory disturbances, and lastly sphincter disturbances. Patients with severe neurological deficits at presentation tend to have worse posttreatment functional outcomes than those with mild or moderate pretreatment disability. However, improvement or stabilization of symptoms is seen in the vast majority of treated patients, and thus treatment is justified even in patients with substantial neurological deficits. The extent of intramedullary spinal cord T2 signal abnormality does not correlate with outcomes and should not be used as a prognostic factor.
Authors:
Jennifer E Fugate; Giuseppe Lanzino; Alejandro A Rabinstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgical focus     Volume:  32     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E17     Citation Subset:  IM    
Affiliation:
Division of Critical Care Neurology, Department of Neurology, and.
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