Heros R C, Debrun G M, Ojemann R G, Lasjaunias P L, Naessens P J
J Neurosurg. 1986 Jan;64(1):134-9. doi: 10.3171/jns.1986.64.1.0134.
A patient presenting with progressive paraparesis was found to have a spinal arteriovenous fistula at the T3-4 vertebral level. The lesion consisted of a direct communication of the anterior spinal artery with a very distended venous varix that drained mostly superiorly to the posterior fossa and simulated a posterior fossa arteriovenous malformation (AVM) on vertebral angiography. The patient was treated by surgical ligation of the fistula through an anterior transthoracic approach. He deteriorated abruptly on the 4th postoperative day, probably because of retrograde thrombosis of the enlarged anterior spinal artery. Over the next few months, he improved to the point of being able to walk with crutches. He has also regained sphincter control. The different types of spinal AVM's are reviewed. Our case does not fit into any of these groups. A new category, Type IV, is proposed to designate direct arteriovenous fistulas involving the intrinsic arterial supply of the spinal cord.
一名表现为进行性双下肢轻瘫的患者被发现于T3 - 4椎体水平存在脊髓动静脉瘘。该病变由脊髓前动脉与一个极度扩张的静脉瘤直接相通组成，该静脉瘤主要向上引流至后颅窝，在椎体血管造影上类似后颅窝动静脉畸形（AVM）。患者通过经胸前路手术结扎瘘管进行治疗。术后第4天他突然病情恶化，可能是由于扩大的脊髓前动脉发生逆行血栓形成。在接下来的几个月里，他有所改善，能够拄拐行走。他也恢复了括约肌控制。文中对不同类型的脊髓AVM进行了综述。我们的病例不符合这些组中的任何一组。因此提出一个新的类别，IV型，用于指定涉及脊髓固有动脉供应的直接动静脉瘘。
