脊髓硬脊膜动静脉瘘1例并文献复习

A Case of Spinal Dural Arteriovenous Fistula and Literature Review

目的探讨脊髓硬脊膜动静脉瘘(spinal dural arteriovenous fistula,SDAVF)的临床表现、发病机制及影像学特点,提高对该病的认识,降低误诊率。方法分析收治的1例脊髓硬脊膜动静脉瘘患者的诊疗过程,同时结合文献复习。结果老年男性患者,以排尿困难为首发症状,随后出现下肢的感觉及运动障碍,病情进行性加重,脊髓MRI可见条状长T2信号,脊髓血管造影显示左侧T10节段可见硬脊膜动静脉瘘。结论SDAVF非常罕见,临床症状不典型,脊髓血管造影是确诊的金标准,该病一经诊断应尽早进行手术治疗。

Objective To investigate the clinical symptoms,pathogenesis,and imaging characteristics of spinal dural arteriovenous fistula(SDAVF)to improve understanding and reduce the misdiagnosis rate.Methods The diagnosis and treatment process of a patient with a spinal dural arteriovenous fistula was analyzed,and the literature review was combined.Results For the elderly male patient,dysuria was the first symptom,followed by sensory and motor impairment of the lower limbs,and the disease was progressively aggravated.Long T2 signals were seen on spinal cord MRI,and spinal angiography showed a dural arteriovenous fistula at the left T10 segment.Conclusion SDAVF is very rare and has untypical clinical symptoms.Spinal angiography is the gold standard for diagnosis.Surgical treatment should be performed as soon as possible after diagnosis.