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<meta name="DC.Title" content="Long-Term Outcome in the Repair of Spinal Cord Perimedullary Arteriovenous Fistulas" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2236" />
<meta name="DC.Date" content="2010-11-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The natural history of PMAVFs, also known as type IV spinal cord AVFs, is incompletely understood. Both open surgical and endovascular approaches have been described as treatment modalities for this disease. The goal of this study was to evaluate the long-term outcome of patients with PMAVFs treated at a single tertiary care institution.

MATERIALS AND METHODS: We conducted a retrospective study of 32 patients with PMAVFs, evaluated between 1983 and 2009. Data were gathered by reviewing outpatient clinic notes, operative and radiologic reports, and spinal angiograms. The PMAVFs were categorized into 1 of 3 types based on the angiographic imaging criteria. Pretreatment and posttreatment ambulation and micturition symptoms were quantified by using the ALS.

RESULTS: Thirty patients underwent corrective procedures, 4 by embolization alone, 11 by surgery alone, and 15 with a combination of the 2. Twenty-eight patients underwent follow-up spinal angiography, with residual shunt noted in 6 patients. The mean follow-up period was 54 months (range, 1–228 months). Analysis of the ALS scores revealed that treatment of PMAVFs, independent of technique, resulted in significant improvement in ambulation but inconsistent changes in micturition. In addition, residual fistula at the time of the follow-up angiogram was associated with worsened neurologic status or lack of improvement. Outcome analysis based on fistula type showed dramatic improvement in ALS ambulation scores (62%) for type 3 fistulas, compared with types 1 and 2 (26% and 27%, respectively).

CONCLUSIONS: Significant improvement in ambulation but in not micturition was observed following treatment. Residual fistula on follow-up angiography was associated with progressive worsening or lack of improvement in neurologic function. Patients with type 3 fistulas were shown to benefit most from treatment, with marked improvement in posttreatment ambulation scores. As endovascular and surgical techniques continue to evolve, further studies are warranted.

ALS
:   Aminoff-Logue scale
Amb
:   ambulation
Angio
:   angiographically
ASA
:   anterior spinal artery
AVF
:   arteriovenous fistula
C
:   cervical
AVM
:   arteriovenous malformation
Combo
:   combination of surgery and endovascular treatment
DAVF
:   dural arteriovenous fistula
Dx
:   diagnosis
EDH
:   epidural hematoma
Embo
:   embolization
FU
:   follow-up posttreatment (postdiagnosis in nontreated patients) in months
Hemato
:   hematomyelia
HHT
:   hereditary hemorrhagic telangiectasia
intraop
:   intraoperative
L
:   lumbar
macroAVF
:   large arteriovenous fistula
microAVF
:   small arteriovenous fistula
Mict
:   micturition
MRI
:   MR imaging
myelo
:   myelopathy
NA
:   not applicable
OR
:   surgery
para
:   paraplegia
PLSA
:   posterolateral spinal artery
PMAVF
:   perimedullary arteriovenous fistula
Post
:   post-treatment
postop
:   postoperative
Pre
:   pretreatment
Pts
:   patients
Rx
:   treatment
SAH
:   subarachnoid hemorrhage
hemorrhage includes SAH, hematomyelia, epidural hematoma; SCAVM
:   spinal cord arteriovenous malformation
sxs
:   symptoms
T
:   thoracic
TTDx
:   time to diagnosis in months
TTRx
:   time to treatment in months" />
<meta name="DC.Contributor" content="L. Antonietti" />
<meta name="DC.Contributor" content="S.A. Sheth" />
<meta name="DC.Contributor" content="V.V. Halbach" />
<meta name="DC.Contributor" content="R.T. Higashida" />
<meta name="DC.Contributor" content="C.F. Dowd" />
<meta name="DC.Contributor" content="M.T. Lawton" />
<meta name="DC.Contributor" content="J.D. English" />
<meta name="DC.Contributor" content="S.W. Hetts" />
<meta name="article:published_time" content="2010-11-01" />
<meta name="article:section" content="Spine" />
<meta name="citation_title" content="Long-Term Outcome in the Repair of Spinal Cord Perimedullary Arteriovenous Fistulas" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The natural history of PMAVFs, also known as type IV spinal cord AVFs, is incompletely understood. Both open surgical and endovascular approaches have been described as treatment modalities for this disease. The goal of this study was to evaluate the long-term outcome of patients with PMAVFs treated at a single tertiary care institution.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We conducted a retrospective study of 32 patients with PMAVFs, evaluated between 1983 and 2009. Data were gathered by reviewing outpatient clinic notes, operative and radiologic reports, and spinal angiograms. The PMAVFs were categorized into 1 of 3 types based on the angiographic imaging criteria. Pretreatment and posttreatment ambulation and micturition symptoms were quantified by using the ALS.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Thirty patients underwent corrective procedures, 4 by embolization alone, 11 by surgery alone, and 15 with a combination of the 2. Twenty-eight patients underwent follow-up spinal angiography, with residual shunt noted in 6 patients. The mean follow-up period was 54 months (range, 1–228 months). Analysis of the ALS scores revealed that treatment of PMAVFs, independent of technique, resulted in significant improvement in ambulation but inconsistent changes in micturition. In addition, residual fistula at the time of the follow-up angiogram was associated with worsened neurologic status or lack of improvement. Outcome analysis based on fistula type showed dramatic improvement in ALS ambulation scores (62%) for type 3 fistulas, compared with types 1 and 2 (26% and 27%, respectively).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Significant improvement in ambulation but in not micturition was observed following treatment. Residual fistula on follow-up angiography was associated with progressive worsening or lack of improvement in neurologic function. Patients with type 3 fistulas were shown to benefit most from treatment, with marked improvement in posttreatment ambulation scores. As endovascular and surgical techniques continue to evolve, further studies are warranted.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_author" content="V.V. Halbach" />
<meta name="citation_author" content="R.T. Higashida" />
<meta name="citation_author" content="C.F. Dowd" />
<meta name="citation_author" content="M.T. Lawton" />
<meta name="citation_author" content="J.D. English" />
<meta name="citation_author" content="S.W. Hetts" />
<meta name="twitter:title" content="Long-Term Outcome in the Repair of Spinal Cord Perimedullary Arteriovenous Fistulas" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/31/10.cover.gif" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The natural history of PMAVFs, also known as type IV spinal cord AVFs, is incompletely understood. Both open surgical and endovascular approaches have been described as treatment modalities for this disease. The goal of this study was to evaluate the long-term outcome of patients with PMAVFs treated at a single tertiary care institution.

MATERIALS AND METHODS: We conducted a retrospective study of 32 patients with PMAVFs, evaluated between 1983 and 2009. Data were gathered by reviewing outpatient clinic notes, operative and radiologic reports, and spinal angiograms. The PMAVFs were categorized into 1 of 3 types based on the angiographic imaging criteria. Pretreatment and posttreatment ambulation and micturition symptoms were quantified by using the ALS.

RESULTS: Thirty patients underwent corrective procedures, 4 by embolization alone, 11 by surgery alone, and 15 with a combination of the 2. Twenty-eight patients underwent follow-up spinal angiography, with residual shunt noted in 6 patients. The mean follow-up period was 54 months (range, 1–228 months). Analysis of the ALS scores revealed that treatment of PMAVFs, independent of technique, resulted in significant improvement in ambulation but inconsistent changes in micturition. In addition, residual fistula at the time of the follow-up angiogram was associated with worsened neurologic status or lack of improvement. Outcome analysis based on fistula type showed dramatic improvement in ALS ambulation scores (62%) for type 3 fistulas, compared with types 1 and 2 (26% and 27%, respectively).

CONCLUSIONS: Significant improvement in ambulation but in not micturition was observed following treatment. Residual fistula on follow-up angiography was associated with progressive worsening or lack of improvement in neurologic function. Patients with type 3 fistulas were shown to benefit most from treatment, with marked improvement in posttreatment ambulation scores. As endovascular and surgical techniques continue to evolve, further studies are warranted.

ALS
:   Aminoff-Logue scale
Amb
:   ambulation
Angio
:   angiographically
ASA
:   anterior spinal artery
AVF
:   arteriovenous fistula
C
:   cervical
AVM
:   arteriovenous malformation
Combo
:   combination of surgery and endovascular treatment
DAVF
:   dural arteriovenous fistula
Dx
:   diagnosis
EDH
:   epidural hematoma
Embo
:   embolization
FU
:   follow-up posttreatment (postdiagnosis in nontreated patients) in months
Hemato
:   hematomyelia
HHT
:   hereditary hemorrhagic telangiectasia
intraop
:   intraoperative
L
:   lumbar
macroAVF
:   large arteriovenous fistula
microAVF
:   small arteriovenous fistula
Mict
:   micturition
MRI
:   MR imaging
myelo
:   myelopathy
NA
:   not applicable
OR
:   surgery
para
:   paraplegia
PLSA
:   posterolateral spinal artery
PMAVF
:   perimedullary arteriovenous fistula
Post
:   post-treatment
postop
:   postoperative
Pre
:   pretreatment
Pts
:   patients
Rx
:   treatment
SAH
:   subarachnoid hemorrhage
hemorrhage includes SAH, hematomyelia, epidural hematoma; SCAVM
:   spinal cord arteriovenous malformation
sxs
:   symptoms
T
:   thoracic
TTDx
:   time to diagnosis in months
TTRx
:   time to treatment in months" />
<meta name="og-title" property="og:title" content="Long-Term Outcome in the Repair of Spinal Cord Perimedullary Arteriovenous Fistulas" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/10/1824" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The natural history of PMAVFs, also known as type IV spinal cord AVFs, is incompletely understood. Both open surgical and endovascular approaches have been described as treatment modalities for this disease. The goal of this study was to evaluate the long-term outcome of patients with PMAVFs treated at a single tertiary care institution.

MATERIALS AND METHODS: We conducted a retrospective study of 32 patients with PMAVFs, evaluated between 1983 and 2009. Data were gathered by reviewing outpatient clinic notes, operative and radiologic reports, and spinal angiograms. The PMAVFs were categorized into 1 of 3 types based on the angiographic imaging criteria. Pretreatment and posttreatment ambulation and micturition symptoms were quantified by using the ALS.

RESULTS: Thirty patients underwent corrective procedures, 4 by embolization alone, 11 by surgery alone, and 15 with a combination of the 2. Twenty-eight patients underwent follow-up spinal angiography, with residual shunt noted in 6 patients. The mean follow-up period was 54 months (range, 1–228 months). Analysis of the ALS scores revealed that treatment of PMAVFs, independent of technique, resulted in significant improvement in ambulation but inconsistent changes in micturition. In addition, residual fistula at the time of the follow-up angiogram was associated with worsened neurologic status or lack of improvement. Outcome analysis based on fistula type showed dramatic improvement in ALS ambulation scores (62%) for type 3 fistulas, compared with types 1 and 2 (26% and 27%, respectively).

CONCLUSIONS: Significant improvement in ambulation but in not micturition was observed following treatment. Residual fistula on follow-up angiography was associated with progressive worsening or lack of improvement in neurologic function. Patients with type 3 fistulas were shown to benefit most from treatment, with marked improvement in posttreatment ambulation scores. As endovascular and surgical techniques continue to evolve, further studies are warranted.

ALS
:   Aminoff-Logue scale
Amb
:   ambulation
Angio
:   angiographically
ASA
:   anterior spinal artery
AVF
:   arteriovenous fistula
C
:   cervical
AVM
:   arteriovenous malformation
Combo
:   combination of surgery and endovascular treatment
DAVF
:   dural arteriovenous fistula
Dx
:   diagnosis
EDH
:   epidural hematoma
Embo
:   embolization
FU
:   follow-up posttreatment (postdiagnosis in nontreated patients) in months
Hemato
:   hematomyelia
HHT
:   hereditary hemorrhagic telangiectasia
intraop
:   intraoperative
L
:   lumbar
macroAVF
:   large arteriovenous fistula
microAVF
:   small arteriovenous fistula
Mict
:   micturition
MRI
:   MR imaging
myelo
:   myelopathy
NA
:   not applicable
OR
:   surgery
para
:   paraplegia
PLSA
:   posterolateral spinal artery
PMAVF
:   perimedullary arteriovenous fistula
Post
:   post-treatment
postop
:   postoperative
Pre
:   pretreatment
Pts
:   patients
Rx
:   treatment
SAH
:   subarachnoid hemorrhage
hemorrhage includes SAH, hematomyelia, epidural hematoma; SCAVM
:   spinal cord arteriovenous malformation
sxs
:   symptoms
T
:   thoracic
TTDx
:   time to diagnosis in months
TTRx
:   time to treatment in months" />
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<script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Long-Term Outcome in the Repair of Spinal Cord Perimedullary Arteriovenous Fistulas","hwUrl":"http://ajnr-stage2.stage.highwire.org/content/31/10/1824","hwPath":"/content/31/10/1824.abstract","hwType":"journal page"},"user":{"hwMemberID":"","hwLoggedIntoInstitutionID":"","hwLoggedIntoInstitution":"","hwAccessUsageTerms":"guest","hwRegisteredUser":"no","hwHasFullTextAccess":"yes","hwEntitled":"no"},"content":{"hwIssueDate":"2010-11-01","hwIssueDateTime":"2010-11-01 00:00:00","hwPublicationDate":"2010-11-17","hwPublicationDateTime":"2010-11-17 19:04:25","hwNlmArticleType":"research-article","hwDOI":"10.3174/ajnr.A2236","hwAuthors":"L. Antonietti,S.A. Sheth,V.V. Halbach,R.T. Higashida,C.F. Dowd,M.T. Lawton,J.D. English,S.W. Hetts","hwContributors":"","hwIsEarlyRelease":"no","hwEissn":"1936-959X","hwPissn":"0195-6108","hwVolume":"31","hwIssue":"10","hwArticleType":"Spine","hwTabView":"main_tab","hwViewType":"abstract","hwAccessType":"Free","hwOpenAccess":"no","hwFreeAccess":"yes","hwTaxonomy":"","hwCorpusCode":"ajnr","hwType":"article","hwSubtitle":null,"hwOverline":null,"hwPisaId":"ajnr;31/10/1824","hwFirstPage":"1824","hwLastPage":"1830","hwIsLatestVersion":"yes","hwIsCurrentIssue":"no","hwIsOpenIssue":"no","hwHasFullText":"yes","hwHasPDF":"yes","hwParentTitle":"American Journal of Neuroradiology: 31 (10)","hwElectronicPubDate":"2010-11-17","hwElectronicPubDateTime":"2010-11-17 19:04:25"}});
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      <h1 class="highwire-cite-title" id="page-title">Long-Term Outcome in the Repair of Spinal Cord Perimedullary Arteriovenous Fistulas</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">L. Antonietti</span>, <span class="highwire-citation-author" data-delta="1">S.A. Sheth</span>, <span class="highwire-citation-author" data-delta="2">V.V. Halbach</span>, <span class="highwire-citation-author" data-delta="3">R.T. Higashida</span>, <span class="highwire-citation-author" data-delta="4">C.F. Dowd</span>, <span class="highwire-citation-author" data-delta="5">M.T. Lawton</span>, <span class="highwire-citation-author" data-delta="6">J.D. English</span> and <span class="highwire-citation-author" data-delta="7">S.W. Hetts</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1824-1830; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2236 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9700--631891868" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">L. Antonietti </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BAntonietti%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Antonietti%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.%2BAntonietti%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">S.A. 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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> The natural history of PMAVFs, also known as type IV spinal cord AVFs, is incompletely understood. Both open surgical and endovascular approaches have been described as treatment modalities for this disease. The goal of this study was to evaluate the long-term outcome of patients with PMAVFs treated at a single tertiary care institution.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> We conducted a retrospective study of 32 patients with PMAVFs, evaluated between 1983 and 2009. Data were gathered by reviewing outpatient clinic notes, operative and radiologic reports, and spinal angiograms. The PMAVFs were categorized into 1 of 3 types based on the angiographic imaging criteria. Pretreatment and posttreatment ambulation and micturition symptoms were quantified by using the ALS.</p>
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<p id="p-4"><strong>RESULTS:</strong> Thirty patients underwent corrective procedures, 4 by embolization alone, 11 by surgery alone, and 15 with a combination of the 2. Twenty-eight patients underwent follow-up spinal angiography, with residual shunt noted in 6 patients. The mean follow-up period was 54 months (range, 1–228 months). Analysis of the ALS scores revealed that treatment of PMAVFs, independent of technique, resulted in significant improvement in ambulation but inconsistent changes in micturition. In addition, residual fistula at the time of the follow-up angiogram was associated with worsened neurologic status or lack of improvement. Outcome analysis based on fistula type showed dramatic improvement in ALS ambulation scores (62%) for type 3 fistulas, compared with types 1 and 2 (26% and 27%, respectively).</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> Significant improvement in ambulation but in not micturition was observed following treatment. Residual fistula on follow-up angiography was associated with progressive worsening or lack of improvement in neurologic function. Patients with type 3 fistulas were shown to benefit most from treatment, with marked improvement in posttreatment ambulation scores. As endovascular and surgical techniques continue to evolve, further studies are warranted.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">ALS<span class="def-item-dt-sep"></span></dt><dd>Aminoff-Logue scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">Amb<span class="def-item-dt-sep"></span></dt><dd>ambulation<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">Angio<span class="def-item-dt-sep"></span></dt><dd>angiographically<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">ASA<span class="def-item-dt-sep"></span></dt><dd>anterior spinal artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">AVF<span class="def-item-dt-sep"></span></dt><dd>arteriovenous fistula<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">C<span class="def-item-dt-sep"></span></dt><dd>cervical<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">AVM<span class="def-item-dt-sep"></span></dt><dd>arteriovenous malformation<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">Combo<span class="def-item-dt-sep"></span></dt><dd>combination of surgery and endovascular treatment<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">DAVF<span class="def-item-dt-sep"></span></dt><dd>dural arteriovenous fistula<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">Dx<span class="def-item-dt-sep"></span></dt><dd>diagnosis<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">EDH<span class="def-item-dt-sep"></span></dt><dd>epidural hematoma<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">Embo<span class="def-item-dt-sep"></span></dt><dd>embolization<span class="def-item-dd-sep"></span></dd><dt id="def-item-13">FU<span class="def-item-dt-sep"></span></dt><dd>follow-up posttreatment (postdiagnosis in nontreated patients) in months<span class="def-item-dd-sep"></span></dd><dt id="def-item-14">Hemato<span class="def-item-dt-sep"></span></dt><dd>hematomyelia<span class="def-item-dd-sep"></span></dd><dt id="def-item-15">HHT<span class="def-item-dt-sep"></span></dt><dd>hereditary hemorrhagic telangiectasia<span class="def-item-dd-sep"></span></dd><dt id="def-item-16">intraop<span class="def-item-dt-sep"></span></dt><dd>intraoperative<span class="def-item-dd-sep"></span></dd><dt id="def-item-17">L<span class="def-item-dt-sep"></span></dt><dd>lumbar<span class="def-item-dd-sep"></span></dd><dt id="def-item-18">macroAVF<span class="def-item-dt-sep"></span></dt><dd>large arteriovenous fistula<span class="def-item-dd-sep"></span></dd><dt id="def-item-19">microAVF<span class="def-item-dt-sep"></span></dt><dd>small arteriovenous fistula<span class="def-item-dd-sep"></span></dd><dt id="def-item-20">Mict<span class="def-item-dt-sep"></span></dt><dd>micturition<span class="def-item-dd-sep"></span></dd><dt id="def-item-21">MRI<span class="def-item-dt-sep"></span></dt><dd>MR imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-22">myelo<span class="def-item-dt-sep"></span></dt><dd>myelopathy<span class="def-item-dd-sep"></span></dd><dt id="def-item-23">NA<span class="def-item-dt-sep"></span></dt><dd>not applicable<span class="def-item-dd-sep"></span></dd><dt id="def-item-24">OR<span class="def-item-dt-sep"></span></dt><dd>surgery<span class="def-item-dd-sep"></span></dd><dt id="def-item-25">para<span class="def-item-dt-sep"></span></dt><dd>paraplegia<span class="def-item-dd-sep"></span></dd><dt id="def-item-26">PLSA<span class="def-item-dt-sep"></span></dt><dd>posterolateral spinal artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-27">PMAVF<span class="def-item-dt-sep"></span></dt><dd>perimedullary arteriovenous fistula<span class="def-item-dd-sep"></span></dd><dt id="def-item-28">Post<span class="def-item-dt-sep"></span></dt><dd>post-treatment<span class="def-item-dd-sep"></span></dd><dt id="def-item-29">postop<span class="def-item-dt-sep"></span></dt><dd>postoperative<span class="def-item-dd-sep"></span></dd><dt id="def-item-30">Pre<span class="def-item-dt-sep"></span></dt><dd>pretreatment<span class="def-item-dd-sep"></span></dd><dt id="def-item-31">Pts<span class="def-item-dt-sep"></span></dt><dd>patients<span class="def-item-dd-sep"></span></dd><dt id="def-item-32">Rx<span class="def-item-dt-sep"></span></dt><dd>treatment<span class="def-item-dd-sep"></span></dd><dt id="def-item-33">SAH<span class="def-item-dt-sep"></span></dt><dd>subarachnoid hemorrhage<span class="def-item-dd-sep"></span></dd><dt id="def-item-34">hemorrhage includes SAH, hematomyelia, epidural hematoma; SCAVM<span class="def-item-dt-sep"></span></dt><dd>spinal cord arteriovenous malformation<span class="def-item-dd-sep"></span></dd><dt id="def-item-35">sxs<span class="def-item-dt-sep"></span></dt><dd>symptoms<span class="def-item-dd-sep"></span></dd><dt id="def-item-36">T<span class="def-item-dt-sep"></span></dt><dd>thoracic<span class="def-item-dd-sep"></span></dd><dt id="def-item-37">TTDx<span class="def-item-dt-sep"></span></dt><dd>time to diagnosis in months<span class="def-item-dd-sep"></span></dd><dt id="def-item-38">TTRx<span class="def-item-dt-sep"></span></dt><dd>time to treatment in months</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/10/1824.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 31</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 10 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 2010 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1824-1830; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2236 </span></div>
  
  
  
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      <div class="highwire-cite-title">Long-Term Outcome in the Repair of Spinal Cord Perimedullary Arteriovenous Fistulas</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1824-1830; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2236 </span></div>
  
  
  
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