The clinical and radiological presentation of spinal dural arteriovenous XXXX .

@entity1 @entity132 @entity12967 @entity101 @entity602 @entity425 @entity292 @entity158
STUDY DESIGN: Retrospective consecutive case series. OBJECTIVE: To assess the symptoms, neurologic signs, and radiologic findings in a large series of @entity1 with @entity602 due to spinal dural arteriovenous @entity292 (SDAVF). SUMMARY OF BACKGROUND: The clinical diagnosis of SDAVF is difficult because presenting symptoms and signs can be similar to those seen with spinal canal stenosis or peripheral nerve or root disorders. METHODS: We reviewed 153 consecutive @entity1 with SDAVF treated surgically at our institution between 1985 and 2008. Before surgery, all @entity1 had detailed neurologic examination, 147 @entity1 had spinal magnetic resonance imaging (MRI) and all but one, had spinal angiography. We evaluated associations between symptoms, physical signs, spinal cord T2 signal abnormality on MRI, and @entity292 level on angiogram. RESULTS: Mean age was 63.5 years and 119 (77.8%) were @entity1 . @entity425 and sensory changes are usually symmetric and ascend from the lower extremities. Presenting symptoms included @entity425 (74 @entity1 , 48.4%), leg @entity132 (41 @entity1 , 26.8%), @entity158 involving back or legs (31 @entity1 , 20.3%), and @entity132 (6 @entity1 , 3.9%). @entity425 with @entity12967 was present in 66 (43.1%) @entity1 and correlated with @entity292 location (P=0.04). Pinprick level was identified in 57 (37.3%) @entity1 ; L1 level (22.8%) was the most common, followed by T10 (19.3%). Fistula level (  2 levels) corresponded to pinprick level in only 40% of these @entity1 . T2 signal abnormality involved the conus in 95% of our @entity1 . Highest cord level of T2 signal hyperintensity (  2 levels) corresponded to pinprick level in 25% of cases. CONCLUSION: Leg weakness exacerbated by exercise, likely due to worsening @entity101 in the arterialized draining vein, is a common manifestation of thoracic SDAVF. Although a sensory level is often found, it cannot reliably guide the level of imaging. Thus, the entire spine should be examined with MRI when an SDAVF is suspected.
