Spinal epidural arteriovenous fistula with improved sphincter impairment detected by intraoperative neurophysiological monitoring

Surgical Neurology International, 2022 · DOI: 10.25259/SNI_592_2022 · Published: August 26, 2022

Surgery Medical Imaging Spinal Disorders

Simple Explanation

Spinal epidural arteriovenous fistulas (SEAVFs) are rare spinal vascular malformations that can cause motor, sensory, and sphincter dysfunction. This case report describes a patient with SEAVF whose sphincter function improved after endovascular treatment, and this improvement was correlated with changes in intraoperative neurophysiological monitoring (IOM). The study highlights the importance of follow-up neurophysiological monitoring to assess the functional recovery of the sphincter after SEAVF treatment.

Study Duration

1.5 years

Participants

A 77-year-old woman

Evidence Level

Case Report

Key Findings

1
A patient with SEAVF experienced improved sphincter function 1.5 years after endovascular embolization.
2
Follow-up angiography revealed no shunt recurrence and improved venous congestion.
3
Anal MEP and BCR were detected during follow-up angiography, indicating neurophysiological improvement in sphincter function.

Research Summary

This case report describes a 77-year-old woman with a spinal epidural arteriovenous fistula (SEAVF) who presented with progressive motor weakness, numbness, and urinary and fecal incontinence. The patient underwent endovascular treatment with intraoperative neurophysiological monitoring (IOM), which initially did not show anal MEP or BCR, but these improved at the 1.5-year follow-up, correlating with clinical improvement in sphincter function. The study concludes that follow-up neurophysiological monitoring is important to assess the functional recovery of the sphincter after embolization of a SEAVF.

Practical Implications

Improved Monitoring

Follow-up neurophysiological monitoring can be a useful tool for assessing the functional recovery of the sphincter after SEAVF treatment.

Treatment Outcomes

IOM can help predict treatment outcomes and prevent neurological complications during embolization of spinal cord vascular malformations.

Pudendal Nerve Injury

Prolonged BCR latency may indicate pudendal nerve injury, potentially reflecting the interval from onset to treatment.

Spinal epidural arteriovenous fistula with improved sphincter impairment detected by intraoperative neurophysiological monitoring

Simple Explanation

Key Findings

Research Summary

Practical Implications

Improved Monitoring

Treatment Outcomes

Pudendal Nerve Injury

Study Limitations

Your Feedback

Was this summary helpful?

Spinal epidural arteriovenous fistula with improved sphincter impairment detected by intraoperative neurophysiological monitoring

Simple Explanation

Key Findings

Research Summary

Practical Implications

Improved Monitoring

Treatment Outcomes

Pudendal Nerve Injury

Study Limitations

Your Feedback

Was this summary helpful?