Endovascular treatment of a spinal dural arteriovenous malformation (DAVF)

Neurosurg Focus. 2014 Jul;37(1 Suppl):1. doi: 10.3171/2014.V2.FOCUS14180.

Abstract

We present a case of a patient with rapid loss of motor strength in his lower extremities. He became bedridden with bowel and bladder incontinence, and developed saddle anesthesia. MRI of the lumbar spine showed edema in the conus medullaris and multiple flow voids within the spinal canal. A spinal angiogram showed a dorsal Type I spinal AVF. This was treated successfully with Onyx 18 (eV3, Irvine, CA). The patient showed rapid post-procedure improvement, and at discharge from the hospital to a rehabilitation center he was fully ambulatory. At 3-year follow-up, the patient was found to ambulate without difficulty. He also had improved saddle anesthesia, and he was voiding spontaneously. There was no evidence of flow voids on repeat MRI of the lumbar spine. The video can be found here: http://youtu.be/SDYNIGNQIW8 .

Keywords: Onyx; carotid; giant aneurysm; thrombosed; video.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Central Nervous System Vascular Malformations / complications
  • Central Nervous System Vascular Malformations / surgery*
  • Drug Combinations
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods*
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Polyvinyls
  • Spinal Cord Diseases / complications
  • Spinal Cord Diseases / surgery*
  • Tantalum

Substances

  • Drug Combinations
  • Onyx 18
  • Polyvinyls
  • Tantalum