Spinal dural arteriovenous fistulas

Abstract

Spinal dural arteriovenous fi stulas are the most commonly encountered vascular malformation of the spinal cord. They are presumably acquired lesions; however, their exact etiology is not known. Most fi stulas are located in the thoracolumbar region. The increase in spinal venous pressure leads to decreased drainage of normal spinal veins, venous congestion, and clinical fi ndings of progressive myelopathy. Because presenting clinical symptoms are usually non-specifi c, the radiologist is often the fi rst to raise the possibility of this diagnosis. On MRI, the combination of cord edema, perimedullary dilated vessels, and cord enhancement is characteristic. There are two treatment options in this patient population: endovascular and surgical occlusion of the shunt.