Spinal dural arteriovenous fistula malformations

To better understand the etiopathogenesis, clinical and radiologic features, and the current treatment and prognosis of spinal dural arteriovenous fistula malformations (SDAVFMs), the authors present an extensive review of the literature. Important points include: 1) SDAVFMs are acquired lesions with a strong male preponderance that usually present in the fifth and sixth decades of life with a symptomatology characterized by a slowly progressive neurologic deterioration: 1) the investigative tool of choice is selective spinal angiography, but magnetic resonance angiography may be useful in the detection of the site of the fistula and as a follow-up modality: 3) surgical closure of the malformation is still the best treatment: 4) the prognosis can be good and the best opportunity for optimal recovery is with early diagnosis and treatment. Once irreversible spinal cord damage has occurred, secondary to increased intraspinal cord venous pressure, the long-term outcome is poor.