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J Neurol Surg A Cent Eur Neurosurg 2019; 80(04): 325-332
DOI: 10.1055/s-0039-1683446
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Simultaneous Diagnosis and Treatment of Double Synchronous Spinal Cord Vascular Malformation

Delia Cannizzaro
1   Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano (MI), Italy
,
Maria Pia Tropeano
1   Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano (MI), Italy
2   Department of Neurology and Psichiatry, “La Sapienza” University of Rome, Rome, Italy
,
Maurizio Fornari
1   Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano (MI), Italy
,
Franco Servadei
1   Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano (MI), Italy
3   Department of Neuroscience, Humanitas University, Rozzano, Lombardia, Italy
,
Andrea Cardia
1   Department of Neurosurgery, Humanitas Clinical and Research Center, Rozzano (MI), Italy
› Author Affiliations
Further Information

Publication History

31 May 2018

17 October 2018

Publication Date:
09 April 2019 (online)

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Abstract

Although multiple concurrent spinal arteriovenous fistulas (DAVFs) are a well-known anatomical and clinical entity, the management of these lesions and timing of surgical intervention is still a matter of debate.

A 74-year-old man with a 2-year history of progressive weakness of both lower limbs and lower back pain was diagnosed angiographically with a thoracic DAVF. During the surgical procedure, double independent spinal DAVFs were identified. With the aid of neurophysiologic monitoring, we proceeded to the closure of both fistulas in a one-step surgery.

Neurophysiologic monitoring represents a valid, widely available, minimally invasive tool for the detection of immediate motor fiber damage due to disruption of the incorrect vessels during DAVF surgery and facilitates a safe treatment in a one-step procedure.

Keywords

spinal vascular malformations - intraoperative neurophysiologic monitoring - double spinal arteriovenous fistulas
 

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