Clinical Outcomes of Patients with Delayed Diagnosis of Spinal Dural Arteriovenous Fistulas.

AJNR. American Journal of Neuroradiology
W BrinjikjiG Lanzino

Abstract

Spinal dural arteriovenous fistulas are commonly missed on imaging or misdiagnosed as inflammatory or neoplastic processes. We reviewed a consecutive series of spinal dural arteriovenous fistulas referred to our institution that were missed or misdiagnosed on initial imaging and studied the clinical consequences of missing or misdiagnosing the lesion. We reviewed spinal dural arteriovenous fistulas diagnosed at our institution between January 1, 2000, and November 1, 2014. A lesion was defined as "misdiagnosed" if initial MR imaging or CT myelography demonstrated characteristic imaging features of spinal dural arteriovenous fistula but the patient was clinically or radiologically misdiagnosed. Outcomes included length of delay of diagnosis, increased disability (increase in mRS or Aminoff motor disability of ≥1 point) between initial imaging evaluation and diagnosis date, and posttreatment disability. Fifty-three consecutive spinal dural arteriovenous fistulas that were initially misdiagnosed despite having characteristic imaging findings on MR imaging or CT myelography were included in our study. Eight patients (18.9%) underwent spinal angiography before referral, which was interpreted as having negative findings but was eithe...Continue Reading

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Citations

Apr 4, 2018·Continuum : Lifelong Learning in Neurology·Christopher L Kramer
Sep 13, 2018·JAMA Neurology·Nicholas L ZalewskiEoin P Flanagan
Sep 14, 2016·Clinical Neuroradiology·Ji Eun ParkDae Chul Suh
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Jul 9, 2017·Current Treatment Options in Neurology·Deena M Nasr, Alejandro Rabinstein
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Feb 2, 2021·Continuum : Lifelong Learning in Neurology·Nicholas L Zalewski
May 20, 2021·Seminars in Neurology·Stephen W English, Nicholas L Zalewski

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