Surgical management of angiographically occult spinal dural arteriovenous fistulae (type I spinal arteriovenous malformations): three technical case reports.

Abstract

Spinal dural arteriovenous fistulae (Type I spinal arteriovenous malformations [AVMs]) have been recognized as a treatable cause of progressive myelopathy. The diagnosis and characterization of these lesions rest heavily on spinal angiography. We present three patients whose clinical presentations were consistent with a spinal dural AVM but whose spinal angiographic results were negative. The surgical treatment of these angiographically occult spinal AVMs is described. In retrospect, in each case, the feeding vessel to the AVM was injected but not seen. Some spinal dural arteriovenous fistulae will be angiographically occult. If the clinical and radiographic presentations strongly suggest the presence of an arteriovenous fistula, surgical exploration should be considered.