Spinal arteriovenous shunts presenting as intracranial subarachnoid haemorrhageReport as inadecuate




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Journal of Neurology

, 254:1044

First Online: 02 April 2007Received: 01 September 2006Accepted: 01 November 2006

Abstract

BackgroundIn approximately 5% of patients with intracranial subarachnoid haemorrhage SAH, the cause is another than a ruptured aneurysm or perimesencephalic haemorrhage. One of these causes is a spinal arteriovenous shunt SAVS. The aim of this study was to investigate the characteristics of patients with SAVS who present with intracranial SAH without symptoms and signs suggesting a spinal cause.

MethodsWe systematically reviewed the literature and searched the SAH database of the University Medical Center Utrecht, The Netherlands, for patients with SAVS presenting with intracranial SAH and studied the characteristics of patients with SAVS whose clinical presentation mimicked intracranial SAH caused by rupture of a saccular aneurysm.

ResultsThirty-five patients were identified after a review of the literature. In our SAH database, comprising 2142 patients included in the period 1985–2004, we found one patient 0.05%, 95 % CI 0.006–0.3%. SAH due to SAVS occurred at any age 4–72 years. The SAVS was located at the craniocervical junction in 14 patients, at the cervical level in 11, and at the thoracolumbar level in the remaining 11 patients. The majority of patients n = 26, 72% had no disabling deficits at discharge or follow-up.

ConclusionRupture of a SAVS presenting as intracranial SAH is rare and can occur at any age. The SAVS can be located not only at the craniocervical junction or cervical level but also in the thoracolumbar region. Most patients with SAVS presenting as intracranial SAH have a good recovery.

Key words subarachnoid haemorrhage spinal arteriovenous shunt Abbreviations AVF:Arteriovenous fistula

AVM:Arteriovenous malformation

CCJ:Craniocervical junction

GOS:Glasgow Outcome Scale

IVH:Intraventricular haemorrhage

LP:Lumbar puncture

SAH:Subarachnoid haemorrhage

SAVS:Spinal arteriovenous shunt

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Author: J. van Beijnum - D. C. G. Straver - G. J. E. Rinkel - C. J. M. Klijn

Source: https://link.springer.com/



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