Spinal dural arteriovenous fistula

The pathology of venous hypertensive myelopathy

Hurst, R. W. MD
Kenyon, L. C. MD, PhD
Lavi, E. MD
Raps, E. C. MD
Marcotte, P. MD

From the Deprtments of Radiology (Dr. Hurst), Pathology (Drs. Kenyon and Lavi), Neurology (Dr. Raps), and Neurosurgery (Dr. Marcotte), University of Pennsylvania Medical Center, Philadelphia, PA.

Address correspondence and reprint requests to Dr. Robert W. Hurst, Dept. of Radiology-Neuroradiology, Hospital of the University of Pennslyvania, 3400 Spruce St., Philadelphia, PA 19104-4228.

Received July 1, 1994. Accepted in final form December 16, 1994.

Neurology 45(7):p 1309-1313, July 1995.

Article abstract

Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal vascular malformation. The arteriovenous shunts, located entirely outside the spinal cord, cause a clinical picture of chronic progressive myelopathy believed to arise from the effects of increased venous pressure and impaired venous drainage on the spinal cord. Despite their well-described clinical and angiographic features, no reports have documented the spinal cord pathology in a case of angiographically or pathologically proven SDAVF. We report such a patient in whom a spinal cord biopsy supported increased venous pressure as a mechanism of neurologic dysfunction.