Type I spinal arteriovenous fistula with ventral intradural venous drainage: A proposal of a modified classification

Nimer Adeeb; Justin Moore; Abdulrahman Alturki; Ketan Bulsara; Christoph Griessenauer; Apar Patel; Raghav Gupta; R Tubbs; Christopher Ogilvy; Ajith Thomas

doi:10.4103/ajns.AJNS_100_17

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2018; 13(04): 1048-1052
DOI: 10.4103/ajns.AJNS_100_17

Original Article

Type I spinal arteriovenous fistula with ventral intradural venous drainage: A proposal of a modified classification

Nimer Adeeb

¹Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

,

Justin Moore

¹Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

,

Abdulrahman Alturki

¹Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

²Department of Neurosurgery, King Fahad Medical City, National Neurosciences Institute, Riyadh, Saudi Arabia

,

Ketan Bulsara

³Department of Neurosurgery, Yale University School of Medicine, New Haven, CT

,

Christoph Griessenauer

¹Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

,

Apar Patel

¹Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

,

Raghav Gupta

¹Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

,

R Tubbs

⁴Seattle Science Foundation, Seattle, WA

,

Christopher Ogilvy

¹Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

,

Ajith Thomas

¹Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

› Author Affiliations

Abstract

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Objectives: Spinal arteriovenous fistula (AVF) is the most common spinal vascular lesion and constitutes an abnormal communication between a feeder artery and a draining vein. Arterialization of the venous plexus leads to venous hypertension; consequent edema and congestion of the spinal cord are associated with progressive neurological decline. Patients and Methods: In this report, we describe two unique cases of type I cervical spinal AVF, in which a radiculomeningeal artery forms an intradural fistula that drains into the ventral venous plexus. Results: Both patients underwent surgical obliteration of the fistula with complete occlusion confirmed on postoperative angiography. Conclusion: Both cases do not fit into the current classification scheme. A modified classification is proposed.

Key-words:

Arteriovenous - arteriovenous fistulas - classification - fistula - spinal - Type I - venous plexus - ventral

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