Asymptomatic spinal dural arteriovenous fistula: case series and systematic review

Kiyoharu Shimizu; Masaaki Takeda; Takafumi Mitsuhara; Shunichi Tanaka; Yushi Nagano; Hitoshi Yamahata; Kaoru Kurisu; Satoshi Yamaguchi

doi:10.3171/2019.5.SPINE181513

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Asymptomatic spinal dural arteriovenous fistula: case series and systematic review

Journal article

Peer reviewed

Asymptomatic spinal dural arteriovenous fistula: case series and systematic review

Kiyoharu Shimizu, Masaaki Takeda, Takafumi Mitsuhara, Shunichi Tanaka, Yushi Nagano, Hitoshi Yamahata, Kaoru Kurisu and Satoshi Yamaguchi

Journal of neurosurgery. Spine, Vol.31(5), pp.733-741

11/01/2019

DOI: 10.3171/2019.5.SPINE181513

PMID: 31323622

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Abstract

OBJECTIVE Spinal dural arteriovenous fistulas (SDAVFs) commonly present with symptoms of myelopathy due to venous congestion in the spinal cord; asymptomatic SDAVFs are rarely encountered. To elucidate the clinical characteristics of asymptomatic SDAVFs, the authors present 5 new cases of asymptomatic SDAVF and report the results of their systematical review of the associated literature. METHODS Rye databases were systematically searched for all relevant English-language articles on SDAVFs published from 1990 to 2018. The clinical features and imaging findings of asymptomatic SDAVFs were collected and compared with those of symptomatic SDAVFs. RESULTS Twenty cases, including the 5 cases from the authors' experience, were found. Asymptomatic SDAVFs were more prevalent in the cervical region (35.0%); cervical lesions account for only 2% of all symptomatic SDAVFs. The affected perimedullary veins tended to drain more cranially (50.0%) than caudally (10.0%). Four cases of asymptomatic SDAVF became symptomatic, 1 case spontaneously disappeared, and the remaining 15 cases were unchanged or surgically treated. CONCLUSIONS The higher prevalence of asymptomatic SDAVFs in the cervical spine might be a distinct feature of asymptomatic SDAVFs. Given that venous congestion is the pathophysiology of a symptomatic SDAVF, abundant collateral venous pathways and unique flow dynamics of the CSF in the cervical spine might prevent asymptomatic cervical SDAVFs from becoming symptomatic. In cases in which venous congestion is avoidable, not all asymptomatic SDAVFs will become symptomatic.

Clinical Neurology

Life Sciences & Biomedicine

Neurosciences & Neurology

Science & Technology

Surgery

Details

Title: Subtitle: Asymptomatic spinal dural arteriovenous fistula: case series and systematic review
Creators: Kiyoharu Shimizu - Hiroshima University
Masaaki Takeda - Hiroshima University
Takafumi Mitsuhara - Hiroshima University
Shunichi Tanaka - Kagoshima University
Yushi Nagano - Kagoshima University
Hitoshi Yamahata - Kagoshima University
Kaoru Kurisu - Hiroshima University
Satoshi Yamaguchi - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Journal of neurosurgery. Spine, Vol.31(5), pp.733-741
DOI: 10.3171/2019.5.SPINE181513
PMID: 31323622
NLM abbreviation: J Neurosurg Spine
ISSN: 1547-5654
eISSN: 1547-5646
Publisher: American Association of Neurological Surgeons
Number of pages: 9
Language: English
Date published: 11/01/2019
Academic Unit: Neurosurgery
Record Identifier: 9984303900602771

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