Spinal dural arteriovenous fistula:a comprehensive review of the history,classification systems,management,and prognosis  

作　　者：Ali Alkhaibary Ahoud Alharbi Nada Alnefaie Hajar Alammar Alshaymaa M.Arishy Noor Alghanim Yazeed M.Aldhfyan Arwa Albaiahy Yahya H.Khormi Wael Alshaya Saad AlQahatani Ahmed Aloraidi Ahmed Alkhani Sami Khairy 

机构地区：[1]College of Medicine,King Saud Bin Abdulaziz University for Health Sciences,Riyadh,Saudi Arabia [2]King Abdullah International Medical Research Center,Riyadh,Saudi Arabia [3]Division of Neurosurgery,Department of Surgery,King Abdulaziz Medical City,Ministry of National Guard-Health Affairs,Riyadh,Saudi Arabia [4]Department of Neurosurgery,National Neurosciences Institute,King Fahad Medical City,Riyadh,Saudi Arabia [5]College of Medicine,Jazan University,Jazan,Saudi Arabia [6]Department of Neurosurgery,King Faisal Specialist Hospital and Research Center,Riyadh,Saudi Arabia [7]Department of Surgery,Faculty of Medicine,Jazan University,Jazan,Saudi Arabia

出　　处：《Chinese Neurosurgical Journal》2024年第1期48-56,共9页中华神经外科杂志（英文）

摘　　要：Spinal dural arteriovenous fistulas account for the majority of spinal vascular malformations.They are typically located in the thoracolumbar region and are diagnosed in the middle-aged and elderly populations.Although spinal dural arteriovenous fistulas have been postulated to be acquired,their exact development remains uncertain.Typically,the arteriovenous shunt is situated close to the spinal nerve root,inside the dura mater,where the blood from the radiculomeningeal artery and radicular vein intermix.Throughout history,there have been multiple classification systems of spinal arteriovenous shunts since 1967.Those were mainly based on the evolution of diagnostic studies as well as the treatment of these lesions.Such classification systems have undergone significant changes over the years.Unlike intracranial dural arteriovenous fistula,spinal dural arteriovenous fistula is progressive in nature.The neurological manifestations,due to venous congestion,tend to be insidious as well as non-specific.These include sensory deficits,such as paresthesia,bilateral and/or unilateral radicular pain affecting the lower limbs,and gait disturbances.Spinal dural arteriovenous fistulas can be suspected on magnetic resonance imaging/magnetic resonance angiography and confirmed by digital subtraction angiography(DSA).The management includes surgery,endovascular therapy,and in selected cases,radiotherapy.The treatment goal of spinal dural arteriovenous fistula is to halt the progression of the disease.The prognosis depends on both the duration of symptoms as well as the clinical condition prior to therapy.The present article comprehensively reviews the pathophysiology,changes in classification systems,natural history,clinical manifestations,radiological features,management,and prognosis.

关 键 词：Connection ENDOVASCULAR MYELOPATHY VASCULAR 

分 类 号：R744.1[医药卫生—神经病学与精神病学]