• Spine · May 2013

    Case Reports

    Spontaneous resolution of a thoracic spinal epidural arteriovenous fistula caused by stabbing injury.

    • Collin Torok, Ilya Laufer, and Philippe Gailloud.
    • Division of Interventional Neuroradiology, The Johns Hopkins Hospital, Baltimore, MD 21287, USA.
    • Spine. 2013 May 15;38(11):E683-6.

    Study DesignA single case is presented of a spontaneously resolving epidural arteriovenous fistula caused by a stab wound.ObjectiveTo demonstrate a unique case of a spontaneously resolving epidural arteriovenous fistula caused by a stab wound, as well as to present a brief review of pathology.Summary Of Background DataSpinal epidural arteriovenous fistulas (SEAVF) are high-flow vascular malformations characterized by an arteriovenous shunt involving the internal vertebral venous plexus (IVVP). SEAVFs can present with intramedullary, subarachnoid or epidural hemorrhages, spinal cord or nerve root compression, and progressive myelopathy secondary to medullary venous hypertension. The type of venous drainage (intradural, extradural, or mixed) strongly influences the mode of presentation. Spontaneous resolution of a spinal vascular malformation is a well-documented yet rare phenomenon.MethodsAngiographical and magnetic resonance images of the lesion were obtained pre- and post spontaneous resolution. A brief review of the topic is also presented.ResultsOur observation identifies stabbing as an unusual mechanism for the formation of a SEAVF, and offers an angiographically documented example of complete spontaneous resolution of this type of vascular malformation. SEAVFs of traumatic origin have been previously reported, but we believe that our observation represents the first documentation of such a lesion being caused by stabbing with subsequent spontaneous resolution.ConclusionSpinal epidural arteriovenous fistulas (SEAVFs) are increasingly diagnosed vascular malformations with the potential to inflict serious neurological damage if not recognized and treated in time. Spontaneous resolution of a spinal vascular malformation is a well-documented yet rare phenomenon. Our observation identifies stabbing as an unusual mechanism for the formation of a SEAVF, and offers an example of complete spontaneous resolution of this type of vascular malformation.

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