Extradural lumbar arteriovenous fistula imitating a synovial cyst: illustrative case.
extradural
spinal fistula
synovial cyst
Journal
Journal of neurosurgery. Case lessons
ISSN: 2694-1902
Titre abrégé: J Neurosurg Case Lessons
Pays: United States
ID NLM: 9918227275606676
Informations de publication
Date de publication:
21 Aug 2023
21 Aug 2023
Historique:
received:
01
06
2023
accepted:
24
07
2023
medline:
20
9
2023
pubmed:
20
9
2023
entrez:
20
9
2023
Statut:
epublish
Résumé
Spinal dural arteriovenous fistula is the most common spinal vascular malformation. It usually presents with neurological deficits due to venous congestive myelopathy. Sometimes, however, the symptoms are radicular and can imitate those of a disc hernia or synovial cyst. In this illustrated case, a 34-year-old male patient presented with radicular pain due to nerve root compression. In the magnetic resonance imaging (MRI) examination of the spine, a synovial cyst was suspected, so the patient underwent no further examination before surgery. Intraoperatively, the authors were surprised to see a vascular malformation, which was shown to be an extradural arteriovenous fistula according to the histopathological examination. In atypical MRI findings of the spine, vascular malformations should be considered. In cases with a spinal dural arteriovenous fistula, the thrombosis risk can be high and lead to a need for prolonged anticoagulation.
Sections du résumé
BACKGROUND
BACKGROUND
Spinal dural arteriovenous fistula is the most common spinal vascular malformation. It usually presents with neurological deficits due to venous congestive myelopathy. Sometimes, however, the symptoms are radicular and can imitate those of a disc hernia or synovial cyst.
OBSERVATIONS
METHODS
In this illustrated case, a 34-year-old male patient presented with radicular pain due to nerve root compression. In the magnetic resonance imaging (MRI) examination of the spine, a synovial cyst was suspected, so the patient underwent no further examination before surgery. Intraoperatively, the authors were surprised to see a vascular malformation, which was shown to be an extradural arteriovenous fistula according to the histopathological examination.
LESSONS
CONCLUSIONS
In atypical MRI findings of the spine, vascular malformations should be considered. In cases with a spinal dural arteriovenous fistula, the thrombosis risk can be high and lead to a need for prolonged anticoagulation.
Identifiants
pubmed: 37728292
doi: 10.3171/CASE23280
pii: CASE23280
pmc: PMC10555559
doi:
pii:
Types de publication
Journal Article
Langues
eng
Références
Neurosurgery. 2008 Oct;63(4):693-98; discussion 698-9
pubmed: 18824942
Radiologe. 2001 Nov;41(11):955-60
pubmed: 11765536
World Neurosurg. 2023 May;173:e250-e297
pubmed: 36787855
J Neurol Sci. 2020 Jun 15;413:116863
pubmed: 32386730
Stroke. 2008 Oct;39(10):2783-94
pubmed: 18635840
J Clin Neurosci. 2020 Mar;73:136-139
pubmed: 31932187
Adv Tech Stand Neurosurg. 2016;(43):111-37
pubmed: 26508408
BMC Neurol. 2021 Sep 21;21(1):366
pubmed: 34548039
Joint Bone Spine. 2022 Mar;89(2):105291
pubmed: 34653602
AJNR Am J Neuroradiol. 2022 Dec;43(12):1722-1729
pubmed: 36396334
J Neurol. 2001 Mar;248(3):197-203
pubmed: 11355153
AJR Am J Roentgenol. 2011 May;196(5):1151-5
pubmed: 21512084
Radiol Case Rep. 2021 Mar 28;16(6):1284-1287
pubmed: 33854665
J Neurosurg. 1990 Jun;72(6):839-50
pubmed: 2140125
AJNR Am J Neuroradiol. 1994 Sep;15(8):1501-7
pubmed: 7985570
Neuroimaging Clin N Am. 2003 Feb;13(1):73-93
pubmed: 12802942
J Neurointerv Surg. 2018 Apr;10(4):415-421
pubmed: 29025963