Article Text

Download PDFPDF
Spinal dural arteriovenous fistulas: clinical features in 80 patients
  1. K Jellema1,
  2. L R Canta2,
  3. C C Tijssen1,
  4. W J van Rooij3,
  5. P J Koudstaal4,
  6. J van Gijn5
  1. 1Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands
  2. 2Department of Neurology, Máxima Medical Centre, Eindhoven, The Netherlands
  3. 3Department of Neuroradiology, St. Elisabeth Hospital, Tilburg, The Netherlands
  4. 4Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
  5. 5Department of Neurology, University Medical Centre, Utrecht, The Netherlands
  1. Correspondence to:
 K Jellema
 Department of Neurology, St. Elisabeth Hospital Tilburg, Hilvarenbeekseweg 60, Tilburg 5022 GC, The Netherlands;


The aim of this study was to describe the clinical spectrum of spinal dural arteriovenous fistulas (SDAF) in a large group of patients. We studied the records of 80 patients who were diagnosed with an SDAF in six hospitals over a 15 year period (1985–2001). We extracted data on demographic variables, initial symptoms, symptoms at the time of diagnosis, level of SDAF, and medical history. Most patients were middle aged men, and most SDAF were located in the midthoracic region. The median time to diagnosis of 80 patients with an SDAF was 15 months (range 7 days–197 months). The most common initial symptoms were gait disturbances (34%), numbness (24%), and paresthesias (21%). At the time of diagnosis, most common symptoms were micturition problems (80%), leg weakness (78%), and numbness in the legs or buttocks (69%). The combination of all three symptoms was present in 58% of patients. Any symptoms or signs related to sacral segments had developed in 67 patients (84%). Fifteen patients (19%) had become wheelchair bound. SDAF is difficult to diagnose, and the delay between first symptoms and treatment is often long. In middle aged men who present with disturbances of gait with ascending motor and sensory deficits, and who subsequently report impaired voiding or other sphincter disturbance, SDAF is one of the first diagnoses that should spring to mind.

  • spinal
  • dural
  • fistula
  • MRI, magnetic resonance imaging
  • SDAF, spinal dural arteriovenous fistulas

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interest: None declared