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Spinal arteriovenous fistula in the lipoma of the filum terminale: A report of two cases and literature review
Journal article   Open access

Spinal arteriovenous fistula in the lipoma of the filum terminale: A report of two cases and literature review

Kiyoharu Shimizu, Takafumi Mitsuhara, Masaaki Takeda and Satoshi Yamaguchi
Surgical neurology international, Vol.12, p.103
03/17/2021
DOI: 10.25259/SNI_80_2021
PMCID: PMC8053458
PMID: 33880208
url
https://doi.org/10.25259/SNI_80_2021View
Published (Version of record) Open Access

Abstract

Background: Filum terminale arteriovenous fistulas (FTAVFs) are rare and their pathogenesis remains unknown. The authors report two cases of FTAVF that arose in the lipoma of the filum terminale. Case Description: The two patients were 72 and 76 years of age, and both presented with a progressive paraparesis. The first patient had an arteriovenous fistula (AVF) located at L5 that was supplied by the anterior spinal artery originating from the left T10 intercostal artery. The second patient's AVF at L3-4 was fed by the anterior spinal artery originating from the left T8 intercostal artery. Both patients underwent partial resection of the filum terminale at the location of the shunts. The pathological examinations revealed that both the AVFs were embedded in the adipose tissue of the filum terminale, revealing the fatty fila that were not visible in preoperative magnetic resonance images. Conclusion: Two cases of FTAVF were successfully treated by obliterating the fistulas through partial resection of the affected fatty filum terminale. The literature review revealed 13 cases of FTAVF concomitant with the lipomas of the filum terminale. Resection and histological evaluation of the filum terminale should be performed to treat and elucidate the pathogenesis of FTAVF.
 Pathology Case Report Fatty filum terminale Filum terminale arteriovenous fistula

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