BACKGROUND Spinal dural arteriovenous fistula(SDAVF)is an extremely rare vascular malformation of the central nervous system that is often confused with degenerative spinal disorders due to similar early symptoms and ...BACKGROUND Spinal dural arteriovenous fistula(SDAVF)is an extremely rare vascular malformation of the central nervous system that is often confused with degenerative spinal disorders due to similar early symptoms and clinical features.Here,we report a case of SDAVF recurrence 8 years after lumbar spine surgery and summarize relevant literature.CASE SUMMARY A 54-year-old male was admitted to our hospital complaining of lower back pain,numbness in both lower extremities and intermittent claudication.Subsequent imaging identified lumbar spinal stenosis.Following surgical treatment,the patient’s symptoms significantly resolved,and he was able to perform daily activities.However,similar symptoms appeared 8 years later,followed by confirmation of SDAVF diagnosis.The patient underwent neurosurgery 7 mo after symptom onset.The follow-up period lasted 14 mo,and the patient remains with marginal neurological symptoms.CONCLUSION This case highlights the importance of prompt SDAVF diagnosis.Due to its nonspecific clinical presentation,the clinical experience of the surgeon and definitive imaging examination are indispensable.Additionally,timely neurosurgery is effective and may significantly improve patient outcomes.展开更多
Background Although there were several clinical and experimental studies discussing the pathogenesis of dural arteriovenous fistula (DAVF), the pathological process leading to intracranial DAVF so far remains unknown ...Background Although there were several clinical and experimental studies discussing the pathogenesis of dural arteriovenous fistula (DAVF), the pathological process leading to intracranial DAVF so far remains unknown In this study, we investigated the expression of vascular growth factors in order to elucidate the possible role of these factors for the development of DAVF and to study the biological activity of this uncommon lesion Methods We examined the histological features, proliferative and angiogenic capacities of the tissue specimens obtained from 6 patients who underwent surgery at our institution Immunohistochemical staining for vascular endothelial growth factor (VEGF), its receptors Flk 1 and Flt 1, ephrin B2, MIB 1 and proliferating cell nuclear antigen (PCNA) was performed using standard immunohistochemical techniques Results A positive immunostaining was found for all antibodies studied except MIB 1, whereas nuclear endothelial expression of PCNA was observed in only 3/6 cases VEGF stained positive in all of the available specimens (6/6) Flk 1 showed a positive immunoreaction in only 2/6 cases and Flt 1 in 4/6 cases Ephrin B2 was expressed in the majority (5/6) of the cases Conclusions These results support the hypothesis that DAVFs might be acquired dynamic vascular malformations with low biological activity Vascular growth factors like VEGF and ephrin B2 might play a pivotal role in the formation of DAVF展开更多
文摘BACKGROUND Spinal dural arteriovenous fistula(SDAVF)is an extremely rare vascular malformation of the central nervous system that is often confused with degenerative spinal disorders due to similar early symptoms and clinical features.Here,we report a case of SDAVF recurrence 8 years after lumbar spine surgery and summarize relevant literature.CASE SUMMARY A 54-year-old male was admitted to our hospital complaining of lower back pain,numbness in both lower extremities and intermittent claudication.Subsequent imaging identified lumbar spinal stenosis.Following surgical treatment,the patient’s symptoms significantly resolved,and he was able to perform daily activities.However,similar symptoms appeared 8 years later,followed by confirmation of SDAVF diagnosis.The patient underwent neurosurgery 7 mo after symptom onset.The follow-up period lasted 14 mo,and the patient remains with marginal neurological symptoms.CONCLUSION This case highlights the importance of prompt SDAVF diagnosis.Due to its nonspecific clinical presentation,the clinical experience of the surgeon and definitive imaging examination are indispensable.Additionally,timely neurosurgery is effective and may significantly improve patient outcomes.
文摘Background Although there were several clinical and experimental studies discussing the pathogenesis of dural arteriovenous fistula (DAVF), the pathological process leading to intracranial DAVF so far remains unknown In this study, we investigated the expression of vascular growth factors in order to elucidate the possible role of these factors for the development of DAVF and to study the biological activity of this uncommon lesion Methods We examined the histological features, proliferative and angiogenic capacities of the tissue specimens obtained from 6 patients who underwent surgery at our institution Immunohistochemical staining for vascular endothelial growth factor (VEGF), its receptors Flk 1 and Flt 1, ephrin B2, MIB 1 and proliferating cell nuclear antigen (PCNA) was performed using standard immunohistochemical techniques Results A positive immunostaining was found for all antibodies studied except MIB 1, whereas nuclear endothelial expression of PCNA was observed in only 3/6 cases VEGF stained positive in all of the available specimens (6/6) Flk 1 showed a positive immunoreaction in only 2/6 cases and Flt 1 in 4/6 cases Ephrin B2 was expressed in the majority (5/6) of the cases Conclusions These results support the hypothesis that DAVFs might be acquired dynamic vascular malformations with low biological activity Vascular growth factors like VEGF and ephrin B2 might play a pivotal role in the formation of DAVF
