Brown Patrick A, Zomorodi Ali R, Gonzalez L Fernando
Department of Radiology, Duke University, Durham, NC, USA.
Department of Neurosurgery, Duke University, Durham, NC, USA.
Handb Clin Neurol. 2017;143:199-213. doi: 10.1016/B978-0-444-63640-9.00019-9.
Spinal dural arteriovenous fistulas (dAVF) are the most common subset of the larger group of spinal vascular malformations. In this chapter, we discuss the definition, epidemiology, clinical presentation, diagnosis, treatment, and outcomes of spinal dAVF. Special attention is given to clinical approach, imaging, and diagnosis with discussion of newer spinal magnetic resonance angiographic techniques. Endovascular management techniques are discussed, including technical and safety considerations for the performance of spinal angiography and various methods of embolization. Embolization media, including liquid embolics, particles, and coils, are introduced. Finally, clinical and imaging outcomes are discussed with attention to the clinical and imaging findings of dAVF recurrence.
脊髓硬脊膜动静脉瘘(dAVF)是较大的脊髓血管畸形组中最常见的类型。在本章中,我们将讨论脊髓硬脊膜动静脉瘘的定义、流行病学、临床表现、诊断、治疗及预后。特别关注临床方法、影像学检查以及诊断,同时探讨更新的脊髓磁共振血管造影技术。还将讨论血管内治疗技术,包括脊髓血管造影操作的技术和安全注意事项以及各种栓塞方法。介绍了栓塞介质,包括液体栓塞剂、颗粒和弹簧圈。最后,讨论临床和影像学预后,并关注dAVF复发的临床和影像学表现。