Clinical and Imaging Findings of Spinal Dural Arteriovenous Fistulas : Misdiagnosis and Outcomes

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  • Takai Keisuke
    Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital

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Other Title
  • 脊髄硬膜動静脈瘻の臨床症状と画像所見の特徴
  • ―誤診と治療予後―

Abstract

<p>  Background : Spinal dural arteriovenous fistulas (DAVFs) are rare and can cause gait and micturition disturbances as well as paresthesias of lower extremities. Misdiagnosis may result in poor clinical outcomes.</p><p>  Methods : Fifty patients treated at the Tokyo Metropolitan Neurological Hospital were retrospectively analyzed.</p><p>  Results : Forty patients (80%) initially received misdiagnosis. At the initial hospital, most patients who underwent thoracic MRI were diagnosed correctly as spinal DAVFs, whereas most patients who underwent lumbar MRI received misdiagnosis such as lumbar stenosis, although they showed thoracic myelopathy, epiconus syndrome, and conus medullaris syndrome. Patients with delayed diagnosis of spinal DAVFs resulted in high rates of additional disability.</p><p>  Conclusion : When common lumbar stenosis fails to explain the symptoms, the possibility of spinal DAVFs should be considered, and thoracic MRI should be performed to confirm the diagnosis.</p>

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