Abstract
Background
Spinal pial arteriovenous fistulae are rare intradural superficial vascular lesion consisting in a direct shunt between spinal pial arteries and veins. The presentation of pial arteriovenous fistula is caused by venous congestion with spinal cord ischemia, mass effect, or hemorrhage. The treatment is surgery or endovascular procedure.
Methods
We illustrate the case of thoracic pial arteriovenous fistula in a 66-year-old female operated with posterior midline approach and B-mode US.
Conclusion
Posterior midline approach with targeted laminotomy using high-speed drill affords an ideal surgical exposure. B-mode US is helpful to detect the fistula and study their relationship with the surrounding structures.
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Ramona Guatta and Alessandro Moiraghi contributed equally to this work.
This article is part of the Topical Collection on Vascular Neurosurgery - Other
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Supplementary file1 The video shows a brief description of clinical and radiological presentation of Th10 ruptured spinal pial arteriovenous fistula. Crucial steps of operative technique are meticulously presented. (MP4 359394 KB)
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Guatta, R., Moiraghi, A., May, A.T. et al. Resection of ruptured spinal pial arteriovenous fistula under ultrasound control: how I do it. Acta Neurochir 164, 55–59 (2022). https://doi.org/10.1007/s00701-021-04858-4
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DOI: https://doi.org/10.1007/s00701-021-04858-4