Spinal dural arteriovenous fistulas: clinical features in 80 patients

被引:135
|
作者
Jellema, K
Canta, LR
Tijssen, CC
van Rooij, WJ
Koudstaal, PJ
van Gijn, J
机构
[1] St Elisabeth Hosp Tilburg, Dept Neurol, NL-5022 GC Tilburg, Netherlands
[2] Maxima Med Ctr, Dept Neurol, Eindhoven, Netherlands
[3] St Elizabeth Hosp, Dept Neuroradiol, Tilburg, Netherlands
[4] Erasmus Med Ctr, Dept Neurol, Rotterdam, Netherlands
[5] Univ Utrecht, Med Ctr, Dept Neurol, Utrecht, Netherlands
来源
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY | 2003年 / 74卷 / 10期
关键词
D O I
10.1136/jnnp.74.10.1438
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The aim of this study was to describe the clinical spectrum of spinal dural arteriovenous fistulas (SDAF) in a large group of patients. We studied the records of 80 patients who were diagnosed with an SDAF in six hospitals over a 15 year period ( 1985 - 2001). We extracted data on demographic variables, initial symptoms, symptoms at the time of diagnosis, level of SDAF, and medical history. Most patients were middle aged men, and most SDAF were located in the midthoracic region. The median time to diagnosis of 80 patients with an SDAF was 15 months ( range 7 days 197 months). The most common initial symptoms were gait disturbances (34%), numbness (24%), and paresthesias (21%). At the time of diagnosis, most common symptoms were micturition problems (80%), leg weakness (78%), and numbness in the legs or buttocks (69%). The combination of all three symptoms was present in 58% of patients. Any symptoms or signs related to sacral segments had developed in 67 patients (84%). Fifteen patients (19%) had become wheelchair bound. SDAF is difficult to diagnose, and the delay between first symptoms and treatment is often long. In middle aged men who present with disturbances of gait with ascending motor and sensory deficits, and who subsequently report impaired voiding or other sphincter disturbance, SDAF is one of the first diagnoses that should spring to mind.
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页码:1438 / 1440
页数:3
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