Abstract：
BACKGROUND: Spinal arteriovenous shunts and spinal dysraphism both have a different underlying cause, disease spectrum and developmental process; hence, these entities rarely coexist in a patient. Here, we reported four cases of coexistence of adult-onset spinal arteriovenous shunt and spinal dysraphism in the same patient along with their therapeutic embolisation. Additionally, we conducted an extensive literature review to explore the potential theories and explanations for this coexistence.
METHODS: We retrospectively searched our imaging database from January 2015 to December 2023 to identify instances of spinal arteriovenous shunts occurring in patients with spinal dysraphism or neural tube defect disorders. MRI and angiographic imaging, clinical presentation, treatment and follow-up were analysed.
RESULTS: Four patients with arteriovenous fistula/shunt and spinal dysraphism were included in the study. The mean age of presentation was 35.5 years. The most common symptoms were sensory disturbance and motor weakness. Arteriovenous fistula or shunt was located at the lumber region in one patient and at the sacral region in three cases. Two patients have a prior history of surgery in first decade. Two patients were treated with glue embolisation. The internal iliac artery was a common feeder in all cases.
CONCLUSIONS: The rare coexistence of neural tube defects with spinal vascular abnormalities should be considered when assessing a middle-aged patient with neural tube defect and myelopathy. Correct diagnosis can help in treatment planning and thereby improve prognosis.
METHODS: We retrospectively searched our imaging database from January 2015 to December 2023 to identify instances of spinal arteriovenous shunts occurring in patients with spinal dysraphism or neural tube defect disorders. MRI and angiographic imaging, clinical presentation, treatment and follow-up were analysed.
RESULTS: Four patients with arteriovenous fistula/shunt and spinal dysraphism were included in the study. The mean age of presentation was 35.5 years. The most common symptoms were sensory disturbance and motor weakness. Arteriovenous fistula or shunt was located at the lumber region in one patient and at the sacral region in three cases. Two patients have a prior history of surgery in first decade. Two patients were treated with glue embolisation. The internal iliac artery was a common feeder in all cases.
CONCLUSIONS: The rare coexistence of neural tube defects with spinal vascular abnormalities should be considered when assessing a middle-aged patient with neural tube defect and myelopathy. Correct diagnosis can help in treatment planning and thereby improve prognosis.
摘要：
背景：脊柱动静脉分流和脊柱发育不良都有不同的根本原因，疾病谱和发育过程；因此，这些实体很少在患者中共存。这里,我们报告了4例成人发作的脊髓动静脉分流术和脊髓发育不良并存的病例,同时进行了治疗性栓塞.此外,我们进行了广泛的文献综述，以探索这种共存的潜在理论和解释。
方法：我们回顾性检索了2015年1月至2023年12月的影像学数据库，以确定脊髓发育不良或神经管缺损患者发生的脊髓动静脉分流的实例。MRI和血管造影成像，临床表现,分析治疗和随访情况。
结果：本研究纳入了4例动静脉瘘/分流和脊髓发育不良患者。呈现的平均年龄为35.5岁。最常见的症状是感觉障碍和运动无力。1例患者的动静脉瘘或分流位于腰椎区域，3例位于the骨区域。两名患者在头十年有手术史。两名患者接受了胶水栓塞治疗。在所有情况下，the内动脉都是常见的支线。
结论：在评估患有神经管缺损和脊髓病的中年患者时，应考虑神经管缺损与脊髓血管异常的罕见共存。正确的诊断可以帮助制定治疗计划，从而改善预后。
方法：我们回顾性检索了2015年1月至2023年12月的影像学数据库，以确定脊髓发育不良或神经管缺损患者发生的脊髓动静脉分流的实例。MRI和血管造影成像，临床表现,分析治疗和随访情况。
结果：本研究纳入了4例动静脉瘘/分流和脊髓发育不良患者。呈现的平均年龄为35.5岁。最常见的症状是感觉障碍和运动无力。1例患者的动静脉瘘或分流位于腰椎区域，3例位于the骨区域。两名患者在头十年有手术史。两名患者接受了胶水栓塞治疗。在所有情况下，the内动脉都是常见的支线。
结论：在评估患有神经管缺损和脊髓病的中年患者时，应考虑神经管缺损与脊髓血管异常的罕见共存。正确的诊断可以帮助制定治疗计划，从而改善预后。
