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Surgery
Triple spinal dural arteriovenous fistula
  1. Davide Boeris1,
  2. Martina Giordano1,
  3. Giacomo Petrella2 and
  4. Marco Cenzato1
  1. 1 Neurosurgery, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
  2. 2 Neurochirurgia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
  1. Correspondence to Dr Davide Boeris; davide.boeris{at}ospedaleniguarda.it

Abstract

Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal vascular malformations. Multiple SDAVFs are unusual and can occur either synchronously or metachronously, as reported in the literature. We report on the unusual case of a woman with three separate SDAVFs, which were surgically treated within the same setting; the postoperative course was characterised by unexplained repeated haematoma formation within the surgical sites. A review of the literature was performed to assess the outcomes of patients with multiple distinct SDAVFs: the data of 19 patients were collected, accounting for 41 SDAVFs. Of these, only two patients had all the SDAVFs treated within the same surgical procedure. Based on our literature review, contemporary surgery is not a predisposing factor to haemorrhage per se; however, we can hypothesise that the uncontrolled deliquoration could account for haematoma formation within the surgical sites.

  • Neuroimaging
  • Neurological injury
  • Spinal cord

https://doi.org/10.1136/bcr-2024-262803

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: DB, MG, GP and MC. The following authors gave final approval of the manuscript: DB and MC. The guarantor of this paper is DB.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.