PDF(Pubmed)
Abstract：
Spinal dural arteriovenous fistula (SDAVF) is among the most common arterial shunt diseases typically found in middle aged or older men. Herein, we aimed to clarify the reasons for misdiagnoses and delayed diagnoses of SDAVF, determine how these affect prognoses, and establish how they can be prevented. We conducted a PubMed/MEDLINE literature search using \"spinal dural arteriovenous fistula\", \"delayed diagnosis\", \"late diagnosis\", and \"misdiagnosis\" terms. We identified 18 articles, including 965 SDAVF cases. Patients were predominantly males (71.8-100.0%) (mean age: 53.5-71.0 years). Misdiagnoses rates varied (17.5-100.0%) and encompassed many conditions. The mean time between early manifestations and confirmed diagnosis was approximately 10-15 months and from the first radiologic image revealing dural arteriovenous fistula (DAVF) features to diagnosis was 9.2-20.7 months. Posttreatment outcomes showed a significant improvement in motor functions, gait, and micturition, particularly in patients exhibiting preoperative symptoms over a short period. SDAVF is frequently misdiagnosed or subject to delayed diagnosis, causing poor clinical outcomes. SDAVF symptoms including progressive lower-limb weakness, paresthesia, and vesicorectal dysfunction are indications for spinal magnetic resonance imaging with subsequent spinal angiography, wherein DAVF is evidenced by extensive T2 hyperintensity and flow-void abnormalities. We reported a representative case with delayed diagnosis.
摘要：
硬脊膜动静脉瘘（SDAVF）是最常见的动脉分流疾病，通常在中年或老年男性中发现。在这里，我们旨在阐明SDAVF误诊和延迟诊断的原因，确定这些如何影响预后，并确定如何预防它们。我们使用“硬脑膜动静脉瘘”进行了PubMed/MEDLINE文献检索，\"延迟诊断\",\"晚期诊断\",和“误诊”术语。我们确定了18篇文章，包括965个SDAVF病例。患者主要为男性（71.8-100.0％）（平均年龄：53.5-71.0岁）。误诊率各不相同（17.5-100.0％），包括许多条件。早期表现与确诊之间的平均时间约为10-15个月，从首次放射学图像显示硬脑膜动静脉瘘（DAVF）特征到诊断的平均时间为9.2-20.7个月。治疗后结果显示运动功能显著改善，步态,和排尿,特别是在短时间内表现出术前症状的患者。SDAVF经常被误诊或延迟诊断，导致不良的临床结果。SDAVF症状包括进行性下肢无力，感觉异常,膀胱直肠功能障碍是脊柱磁共振成像和随后的脊髓血管造影的适应症，其中DAVF由广泛的T2高强度和流空异常证明。我们报告了一例延迟诊断的代表性病例。
