NDLI: Type I spinal arteriovenous fistulae exception: a case for reclassification.

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Type I spinal arteriovenous fistulae exception: a case for reclassification.

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Type I spinal arteriovenous fistulae exception: a case for reclassification.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Bulsara, K. R. Hebert, R. Gimbel, D. Abbed, K.
Description	Country affiliation: United States Author Affiliation: Bulsara KR ( Yale Department of Neurosurgery, Neurovascular and Spine Sections, 333, Cedar Street, TMP 4, New Haven, 06520 CT, USA. Ketan.bulsara@yale.edu)
Abstract	OBJECTIVE: Type I spinal arteriovenous lesions represent dorsal dural arteriovenous fistulae with no spinal artery involvement. We report an exception to this and propose dividing Type I lesions into dorsal and ventral categories. METHODS: A 51-year-old patient presented with a partial Brown-Sequard syndrome. An angiogram revealed a spinal arteriovenous fistula, most prominently being fed a radicular artery arising from the right vertebral artery with only ventral venous drainage. RESULTS: This feeder was selected and embolized with onyx, however residual fistula persisted and the patient subsequently underwent microsurgical disconnection. At six-month follow-up, patient motor deficits have resolved and difficulty with proprioception is improving. CONCLUSION: Type I dural arteriovenous fistulae are associated with dorsal venous drainage. Our case demonstrates an exception to this. Recognizing this exception was crucial, because it allowed for simple microsurgical disconnection. We propose that type I dural arteriovenous fistulae be subdivided into ventral and dorsal based on their drainage pattern. This differentiation is critical because lesions with ventral drainage have traditionally been classified as type IV. These lesions have a different treatment method given involvement of spinal arteries.
File Format	HTM / HTML
ISSN	00283770
Issue Number	2
Volume Number	59
e-ISSN	17730619
Journal	Neurochirurgie
Language	English
Publisher	Elsevier
Publisher Date	2013-04-01
Publisher Place	France
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Neurosurgery Arteriovenous Fistula Surgery Brown-sequard Syndrome Central Nervous System Vascular Malformations Diagnosis Pathology Cerebral Angiography Methods Dura Mater Embolization, Therapeutic Humans Middle Aged Spinal Cord Blood Supply Treatment Outcome Case Reports Journal Article
Content Type	Text
Resource Type	Case study Article
Subject	Neurology (clinical) Surgery

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