Multiple Synchronous CSF-Venous Fistulas in Spontaneous Intracranial Hypotension: A Multi-Institutional Case Series.

Ajay A Madhavan, Timothy J Amrhein, Michelle L Kodet, Niklas Lutzen, Michael D Malinzak, Jeremy K Cutsforth-Gregory, Ian T Mark, Ivan Garza, Eike I Piechowiak, Lalani Carlton Jones
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Abstract

CSF-venous fistulas are a common cause of spontaneous intracranial hypotension. Due to the more routine use of decubitus myelography and advancements in various imaging techniques, recognition of CSF-venous fistulas has increased in recent years. Most commonly, patients harbor only one fistula at the time of myelography (although additional de novo fistulas can arise after treatment). Occasionally, two synchronous CSF-venous fistulas may be seen on a single myelogram. The co-existence of more than two CSF-venous fistulas, however, is quite rare and has only been previously described in two instances. Here, we present a multi-institutional series of sixteen patients with three or more concurrently discovered CSF-venous fistulas, representing the largest cohort of such patients to date. We describe their clinical features, imaging findings, treatment approaches, and outcomes.ABBREVIATIONS: CVF = CSF-venous fistula; CB-CTM = cone beam CT myelogram; DSM = digital subtraction myelography; EID = energy integrating detector; SIH = spontaneous intracranial hypotension; PCD = photon counting detector.

自发性颅内低血压并发多个csf -静脉瘘:一个多机构病例系列。
csf -静脉瘘是自发性颅内低血压的常见原因。由于卧位脊髓造影的常规使用和各种成像技术的进步,近年来对csf静脉瘘的认识有所增加。最常见的是,患者在骨髓造影时只有一个瘘管(尽管治疗后可能会出现新的瘘管)。偶尔,两个同步的csf -静脉瘘可以在单个骨髓图上看到。然而,同时存在两个以上的csf静脉瘘是非常罕见的,以前只报道过两个病例。在这里,我们介绍了一个多机构的16例同时发现三个或更多csf静脉瘘的患者,代表了迄今为止这类患者的最大队列。我们描述了他们的临床特征、影像学表现、治疗方法和结果。缩写:CVF = csf -静脉瘘;CB-CTM =锥束CT骨髓显像;数字减影脊髓造影术;EID =能量积分检测器;自发性颅内低血压;光子计数检测器。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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