Wang Yiheng, Yu Jinlu
Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
Med Int (Lond). 2021 Dec 28;2(1):1. doi: 10.3892/mi.2021.26. eCollection 2022 Jan-Feb.
Spinal perimedullary arteriovenous fistula (PAVF) of the conus medullaris and cauda equina supplied by the artery of Desproges-Gotteron (ADG) is rare. The present study reports such a rare case and also presents a brief literature review. The patient described herein was a 31-year-old female. She suffered sudden weakness in the lower limbs, a condition which was then gradually aggravated. A physical examination revealed paraplegia, and urination and defecation difficulties. Spinal magnetic resonance imaging (MRI) and computed tomography angiography (CTA) revealed extensive perimedullary vein dilation with the involvement of the ADG as the main feeding artery. Digital subtraction angiography (DSA) confirmed a high-flow PAVF supplied by the ADG and artery of Adamkiewicz (AKA). Microsurgical treatment under intraoperative DSA assistance was performed. The PAVF was resected, and immediately following DSA confirmed the complete removal of the PAVF. Following discharge, the patient was prescribed rehabilitation exercises and gradually recovered. A follow-up CTA and MRI confirmed that the PAVF was cured, and her modified Rankin scale score was 2. Therefore, as demonstrated herein, microsurgery with intraoperative DSA assistance may be considered an effective treatment option for PAVFs with ADG.
由德斯普罗热 - 戈特龙动脉（ADG）供血的圆锥和马尾脊髓周围动静脉瘘（PAVF）较为罕见。本研究报告了这样一例罕见病例，并进行了简要的文献综述。本文所述患者为一名31岁女性。她突然出现下肢无力，随后病情逐渐加重。体格检查发现截瘫以及排尿和排便困难。脊髓磁共振成像（MRI）和计算机断层血管造影（CTA）显示广泛的脊髓周围静脉扩张，主要供血动脉为ADG。数字减影血管造影（DSA）证实为高流量PAVF，由ADG和Adamkiewicz动脉（AKA）供血。在术中DSA辅助下进行了显微手术治疗。切除了PAVF，DSA随即证实PAVF已完全切除。出院后，患者接受康复锻炼并逐渐康复。随访的CTA和MRI证实PAVF已治愈，其改良Rankin量表评分为2分。因此，如本文所示，术中DSA辅助下的显微手术可被视为治疗由ADG供血的PAVF的有效治疗选择。
