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Neurology, Neuropsychiatry, Psychosomatics

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Spinal dural arteriovenous fistulas: Pathogenesis, clinical manifestations, diagnosis, treatment

https://doi.org/10.14412/2074-2711-2015-3-4-9

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Abstract

The paper describes spinal dural arteriovenous fistulas (SDAVF), the most common type of spinal cord vascular anomalies. SDAVFs account for 60–80% of the spinal cord vascular anomalies. The causes of SDAVFs, the specific features of their hemodynamics, and their classification remain the subject matter of disputes.

SDAVFs form in dura mater tissue, on the dorsal surface of radicular cuffs. The pathogenesis of neurological disorders in SDAVF has determined the name «venous hypertensive myelopathy», a spinal cord injury occurring in their presence. Pain and paresthesias, cacesthesia (more commonly in their distal parts), and motor disorders as flail legs are observed at the onset of SDAVF in typical cases. On average, 12 to 44 months elapse to establish its diagnosis. In addition of motor and sensory disorders, sphincter impairments and sexual dysfunction are detected in the patients at the time of diagnosis. By this time, most patients have already neurological disability.

The paper presents the history of studying SDAVF, the existing classifications of arteriovenous malformations and fistulas, the clinical manifestations of venous hypertensive myelopathy in SDAVF, neuroimaging findings, and treatment options.

About the Authors

G. Yu. Evzikov
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurger,

11, Rossolimo St., Build. 1, Moscow 119021



D. V. Bublievsky
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurger,

11, Rossolimo St., Build. 1, Moscow 119021



S. A. Kondrashin
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation

Department of Radiodiagnosis and Radiotherapy,

6, B. Pirogovskaya St., Moscow 119991



V. E. Sinitsyn
Radiodiagnosis Center, Therapy and Rehabilitation Center, Ministry of Health of Russia
Russian Federation
3, Ivankovskoe Shosse, Moscow 125367


E. V. Shashkova
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation

Department of Radiodiagnosis and Radiotherapy,

6, B. Pirogovskaya St., Moscow 119991



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For citation:


Evzikov G.Y., Bublievsky D.V., Kondrashin S.A., Sinitsyn V.E., Shashkova E.V. Spinal dural arteriovenous fistulas: Pathogenesis, clinical manifestations, diagnosis, treatment. Neurology, Neuropsychiatry, Psychosomatics. 2015;7(3):4-9. (In Russ.) https://doi.org/10.14412/2074-2711-2015-3-4-9

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)