Diffusion MRI in spinal dural arterio-venous fistula: a case report

Sibon, Igor; Ménégon, Patrice; Tafer, Nadir; Dousset, V.

doi:10.1038/sj.sc.3101859

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…3 As in the brain, vasogenic edema in the spinal cord causes increased ADC value from the acute phase. 4 In our patient, longitudinally extensive expansion of the lesion observed on day 10 was accompanied by an increased ADC value in the acute phase, suggesting vasogenic edema. Several characteristic features, including expansion beyond the arterial territory, minimal neurological deterioration, and spontaneous radiological improvement without atrophy in 10 days, support this interpretation.…”

Section: Discussionsupporting

confidence: 54%

“…In spinal cord infarction, high intensity on DWI appears approximately 3 h after onset and ADC values decrease in the acute phase, which normalize 7–20 days after onset . As in the brain, vasogenic edema in the spinal cord causes increased ADC value from the acute phase . In our patient, longitudinally extensive expansion of the lesion observed on day 10 was accompanied by an increased ADC value in the acute phase, suggesting vasogenic edema.…”

Section: Discussionsupporting

confidence: 54%

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Longitudinally extensive vasogenic edema following spinal cord infarction

Gondo

Kurihara

Sugiyama

et al. 2018

Neurology & Clinical Neurosc

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Although transient lesion expansion has been reported after spinal cord infarction, longitudinally extensive lesion expanding more than several vertebral segments is extremely rare. We report a 45‐year‐old man having spinal cord infarction with subsequent longitudinally extensive lesion expansion on magnetic resonance imaging (MRI) 10 days after the infarction. The length of T2 hyperintense lesion was four vertebral segments on initial MRI but enlarged to span 12 vertebral segments on subsequent MRI, with Lhermitte's sign, but otherwise without neurological deterioration. The expanded lesion extended beyond the anterior spinal artery region with high apparent diffusion coefficient value in the acute phase but improved within 10 days after starting cervical collar, suggesting that lesion expansion was due to vasogenic edema. This case illustrates that transient longitudinal lesion expansion accompanied by spinal cord infarction can reach lengths of up to 12 vertebral segments. Caution should be exercised while interpreting MRI findings to avoid excessive treatment or secondary damage.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionsupporting

confidence: 54%

Longitudinally extensive vasogenic edema following spinal cord infarction

Gondo

Kurihara

Sugiyama

et al. 2018

Neurology & Clinical Neurosc

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“…Both with dural AVF after 2 months of treatment. 16) In our case, the ADC value was normalized only 1 week after endovascular intervention, but T 2 -weighted MR imaging still showed abnormal intramedullary hyperintensity. The pathological improvement of the spinal cord was dramatic after flow reduction in the AVF.…”

Section: Discussionmentioning

confidence: 93%

Congestive Myelopathy Due to Cervical Perimedullary Arteriovenous Fistula Evaluated by Apparent Diffusion Coefficient Values-Case Report-

Inoue

Takahashi

Shimizu

et al. 2006

Neurol. Med. Chir.(Tokyo)

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A 22-year-old woman presented with a cervical perimedullary arteriovenous fistula (AVF) manifesting as right upper and lower extremity weakness. T 2 -weighted magnetic resonance (MR) imaging showed intramedullary hyperintensity believed to be caused by venous congestion. Preoperative diffusionweighted MR imaging showed increased apparent diffusion coefficient (ADC) value. Spinal angiography demonstrated an AVF fed mainly by the right C-5 radicular artery. Complete obliteration of AVF was achieved by endovascular embolization and microsurgical shunt occlusion. The ADC value was normalized and her neurological deficits improved after endovascular surgery, whereas T 2 -weighted MR imaging still demonstrated the lesion. The high preoperative ADC value probably indicated reversible vasogenic edema and immediate normalization of the ADC value suggests a good clinical outcome.

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“…Radiological findings frequently disappear after treatment and are often correlated with clinical symptoms [14]. A recent report suggested that diffusion-weighted imaging and apparent diffusion coefficient maps might be useful to identify the vasogenic edema caused by SDAVFs [15]. Contrast-enhanced MR angiography [16][17][18] and multislice computerized tomographic (CT) angiography [19] may facilitate the diagnostic procedure.…”

Section: Introductionmentioning

confidence: 99%

Endovascular and surgical treatment of spinal dural arteriovenous fistulas

et al. 2008

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We conclude that both endovascular and surgical treatment of SDAVFs resulted in a good and lasting clinical outcome in the majority of cases. In specific situations, when a secondary neurosurgical approach was required after endovascular treatment to achieve complete occlusion of the SDAVF, the clinical outcome was rather poor. The best first line treatment modality for each individual patient should be determined by an interdisciplinary team.

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Diffusion MRI in spinal dural arterio-venous fistula: a case report

Cited by 7 publications

References 11 publications

Longitudinally extensive vasogenic edema following spinal cord infarction

Longitudinally extensive vasogenic edema following spinal cord infarction

Congestive Myelopathy Due to Cervical Perimedullary Arteriovenous Fistula Evaluated by Apparent Diffusion Coefficient Values-Case Report-

Endovascular and surgical treatment of spinal dural arteriovenous fistulas

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