PMC4466787_01
(a) Preoperative T2 magnetic resonance imaging (MRI) of patient 1 showing the serpiginous veins surrounding the thoracic spinal cord most prominent at T7/8 level (arrowed), secondary to the dural arteriovenous fistula (DAVF). (b) Preoperative super-selective angiography of patient 1 showing the DAVF fed by the right T7 radicular artery (arrowed). (c) Preoperative T2 MRI of patient 2 showing the serpiginous veins surrounding the thoracic cord most prominent at T8/9 level (arrowed), secondary to the DAVF. (d) Postoperative T2 MRI of patient 1 showing the resolution of venous engorgement around the thoracic spinal cord (arrowed)
SNI-6-99-g001.jpg
PMC4466787_02_SNI-6-99-g001.jpg
F1
Similar to patient 1, MRI [Figure 1c] and spinal digital subtraction angiogram confirmed the presence of a right T7 SDAVF. Patient 1's lower limbs power recovered completely in 6 months, with MRI confirmed resolution of venous engorgement around the spinal cord [Figure 1d].
PMC4466787_02
(a) Preoperative T2 magnetic resonance imaging (MRI) of patient 1 showing the serpiginous veins surrounding the thoracic spinal cord most prominent at T7/8 level (arrowed), secondary to the dural arteriovenous fistula (DAVF). (b) Preoperative super-selective angiography of patient 1 showing the DAVF fed by the right T7 radicular artery (arrowed). (c) Preoperative T2 MRI of patient 2 showing the serpiginous veins surrounding the thoracic cord most prominent at T8/9 level (arrowed), secondary to the DAVF. (d) Postoperative T2 MRI of patient 1 showing the resolution of venous engorgement around the thoracic spinal cord (arrowed)
SNI-6-99-g001.jpg
PMC4466787_02_SNI-6-99-g001.jpg
F1
Similar to patient 1, MRI [Figure 1c] and spinal digital subtraction angiogram confirmed the presence of a right T7 SDAVF. Patient 1's lower limbs power recovered completely in 6 months, with MRI confirmed resolution of venous engorgement around the spinal cord [Figure 1d].
(a) Operative view through the tubular retractor under a surgical microscope, showing dilated serpiginous veins (arrowed) after opening the dura. (b) Dissection of the fistulous point of the spinal dural arteriovenous fistula (arrowed) at the junction of the nerve root sleeve. (c) Water-tight primary dura closure with polypropylene sutures (arrowed)
SNI-6-99-g002.jpg
PMC4466787_02_SNI-6-99-g002.jpg
F2
Through a small durotomy, an arterialized vein was traced to the fistulous point of the SDAVF at the junction of the nerve root sleeve [Figure 2a and b]. The fistula was coagulated and divided. Primary water-tight dura closure was made with 4/0 polypropylene sutures [Figure 2c].