Department of Radiology, Chengdu Shangjin Nanfu Hospital, Sichuan University, Chengdu, PR China.
Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, PR China.
Br J Neurosurg. 2023 Dec;37(6):1797-1800. doi: 10.1080/02688697.2021.1916434. Epub 2021 May 13.
Sacral dural arteriovenous fistulas (DAVFs) with bilateral arterial supplies are extremely rare. To date, only two cases with arterial supply from bilateral lateral sacral arteries (LSAs) were reported. We report a rare case of sacral DAVF with arterial supply from bilateral LSAs. A 56-year-old man presented with a 2-month history of progressive weakness and numbness in his lower extremities, along with urinary incontinence. Spinal magnetic resonance imaging (MRI) showed extensive edema of the spinal cord, vascular flow voids, and intraparenchymal enhancement. Spinal angiography revealed a spinal DAVF at the level of S1 supplied by bilateral LSAs and drained ascending into the perimedullary venous plexus. The fistula was successfully treated with endovascular embolization. Sacral DAVFs present various diagnostic and treatment difficulties because of the complex angioarchitecture. Successful management of these lesions requires a profound understanding of the variable patterns of arterial supply in this region.
骶部硬脑膜动静脉瘘（DAVF）双侧动脉供血极为罕见。迄今为止，仅有两例报告显示动脉供应来自双侧骶外侧动脉（LSAs）。我们报告一例罕见的骶部 DAVF 病例，其动脉供应来自双侧 LSAs。一名 56 岁男性，因下肢进行性无力和麻木以及尿失禁就诊，病史为 2 个月。脊髓磁共振成像（MRI）显示脊髓广泛水肿、血管流空和实质内强化。脊髓血管造影显示 S1 水平的脊髓 DAVF 由双侧 LSAs 供血，向上引流至髓周静脉丛。瘘通过血管内栓塞成功治疗。由于血管结构复杂，骶部 DAVF 存在各种诊断和治疗困难。成功治疗这些病变需要深刻理解该区域动脉供应的多变模式。
