SPINAL DURAL ARTERIOVENOUS-FISTULA

Clinical and neuroradiological findings of 8 patients with a spinal du ral arteriovenous fistula are reviewed Disturbance of micturition or d efecation and weakness of the legs were always present and the most fr equent initial symptom was a progressive spastic paraparesis. Duration of symptoms before diagnosis was 2 years. Lumbar puncture showed elev ation of proteins and myelography demonstrated dilated perimedullar po sterior veins. In every case, magnetic resonance imaging of the the sp inal cord (T2-weighted images) revealed intramedullary high signal int ensity of the conus medullaris and selective angiography confirmed the site of the dural fistula. Each patient was treated with endovascular method consisting in liquid adhesive embolization (0,2 cc of N-butyl cyanoacrylate) with hyperselective catheterism of the dorsospinal arte ry. Embolization procedure was successful in 6 cases with large improv ment of leg weakness and partial regression of disturbed micturition a nd defecation. The pathophysiological mechanisms explaining the clinic al signs are discussed.