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Coexisting filum terminale arteriovenous fistula and filum terminale lipoma treated with single-stage surgery: illustrative case

BACKGROUND: Both filum terminale arteriovenous fistulas (FTAVFs) and filum terminale lipomas (FTLs) are rare. Because of this rarity, there is a paucity of data regarding concomitant FTAVF and FTL, and the optimal treatment remains to be defined. The authors describe a patient with coexisting FTAVF...

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Autores principales: Yamazaki, Hiroki, Ozaki, Tomohiko, Kidani, Tomoki, Fujimi, Yosuke, Nonaka, Masahiro, Umegaki, Masao, Yokota, Chisato, Fujinaka, Toshiyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Association of Neurological Surgeons 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844529/
https://www.ncbi.nlm.nih.gov/pubmed/36647255
http://dx.doi.org/10.3171/CASE22474
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author Yamazaki, Hiroki
Ozaki, Tomohiko
Kidani, Tomoki
Fujimi, Yosuke
Nonaka, Masahiro
Umegaki, Masao
Yokota, Chisato
Fujinaka, Toshiyuki
author_facet Yamazaki, Hiroki
Ozaki, Tomohiko
Kidani, Tomoki
Fujimi, Yosuke
Nonaka, Masahiro
Umegaki, Masao
Yokota, Chisato
Fujinaka, Toshiyuki
author_sort Yamazaki, Hiroki
collection PubMed
description BACKGROUND: Both filum terminale arteriovenous fistulas (FTAVFs) and filum terminale lipomas (FTLs) are rare. Because of this rarity, there is a paucity of data regarding concomitant FTAVF and FTL, and the optimal treatment remains to be defined. The authors describe a patient with coexisting FTAVF and FTL treated with single-stage surgery. OBSERVATIONS: A man in his 70s was referred to the authors’ department because of a suspected spinal vascular malformation seen on magnetic resonance imaging that was performed to investigate lower limb weakness, intermittent claudication, and urinary incontinence. Previous imaging had shown a terminal lipoma with an internal flow void. Computed tomography angiography and digital subtraction angiography revealed an FTAVF, the feeder being a lateral sacral artery. The patient was treated surgically with curative intent. The FTL and tethered cord that had been identified by imaging were treated in the same procedure. Postoperative digital subtraction angiography showed absence of the abnormal vessels. The patient was discharged home on the 19th postoperative day. LESSONS: When considering treatment, it is important to determine whether symptoms are attributable mainly to FTL, tethered cord, or FTAVF. One-stage treatment is useful because it eliminates both the FTAVF and the factors that led to its development.
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spelling pubmed-98445292023-01-19 Coexisting filum terminale arteriovenous fistula and filum terminale lipoma treated with single-stage surgery: illustrative case Yamazaki, Hiroki Ozaki, Tomohiko Kidani, Tomoki Fujimi, Yosuke Nonaka, Masahiro Umegaki, Masao Yokota, Chisato Fujinaka, Toshiyuki J Neurosurg Case Lessons Case Lesson BACKGROUND: Both filum terminale arteriovenous fistulas (FTAVFs) and filum terminale lipomas (FTLs) are rare. Because of this rarity, there is a paucity of data regarding concomitant FTAVF and FTL, and the optimal treatment remains to be defined. The authors describe a patient with coexisting FTAVF and FTL treated with single-stage surgery. OBSERVATIONS: A man in his 70s was referred to the authors’ department because of a suspected spinal vascular malformation seen on magnetic resonance imaging that was performed to investigate lower limb weakness, intermittent claudication, and urinary incontinence. Previous imaging had shown a terminal lipoma with an internal flow void. Computed tomography angiography and digital subtraction angiography revealed an FTAVF, the feeder being a lateral sacral artery. The patient was treated surgically with curative intent. The FTL and tethered cord that had been identified by imaging were treated in the same procedure. Postoperative digital subtraction angiography showed absence of the abnormal vessels. The patient was discharged home on the 19th postoperative day. LESSONS: When considering treatment, it is important to determine whether symptoms are attributable mainly to FTL, tethered cord, or FTAVF. One-stage treatment is useful because it eliminates both the FTAVF and the factors that led to its development. American Association of Neurological Surgeons 2023-01-16 /pmc/articles/PMC9844529/ /pubmed/36647255 http://dx.doi.org/10.3171/CASE22474 Text en © 2023 The authors https://creativecommons.org/licenses/by-nc-nd/4.0/CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ).
spellingShingle Case Lesson
Yamazaki, Hiroki
Ozaki, Tomohiko
Kidani, Tomoki
Fujimi, Yosuke
Nonaka, Masahiro
Umegaki, Masao
Yokota, Chisato
Fujinaka, Toshiyuki
Coexisting filum terminale arteriovenous fistula and filum terminale lipoma treated with single-stage surgery: illustrative case
title Coexisting filum terminale arteriovenous fistula and filum terminale lipoma treated with single-stage surgery: illustrative case
title_full Coexisting filum terminale arteriovenous fistula and filum terminale lipoma treated with single-stage surgery: illustrative case
title_fullStr Coexisting filum terminale arteriovenous fistula and filum terminale lipoma treated with single-stage surgery: illustrative case
title_full_unstemmed Coexisting filum terminale arteriovenous fistula and filum terminale lipoma treated with single-stage surgery: illustrative case
title_short Coexisting filum terminale arteriovenous fistula and filum terminale lipoma treated with single-stage surgery: illustrative case
title_sort coexisting filum terminale arteriovenous fistula and filum terminale lipoma treated with single-stage surgery: illustrative case
topic Case Lesson
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9844529/
https://www.ncbi.nlm.nih.gov/pubmed/36647255
http://dx.doi.org/10.3171/CASE22474
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