From the Research
The draining veins in a spinal dural arteriovenous fistula (SDAVF) typically include the radicular veins, perimedullary veins, and coronal venous plexus, with the primary drainage occurring through the radicular vein, as seen in a case report from 1. The primary drainage occurs through the radicular vein, which is the direct recipient of abnormal arteriovenous shunting from a dural branch of a radicular artery.
- This radicular vein then drains into the perimedullary venous system, which includes longitudinal venous channels running along the spinal cord surface, as described in 2.
- The coronal venous plexus, which encircles the spinal cord, also becomes involved in the drainage pathway, as noted in 3. These veins often appear tortuous, dilated, and serpentine on imaging studies due to increased pressure and flow from the arteriovenous shunt, as seen in a study from 4. The abnormal venous drainage pattern leads to venous hypertension and congestion of the spinal cord, which is responsible for the progressive myelopathy typically seen in patients with SDAVF, as discussed in 5. Understanding these venous drainage patterns is crucial for proper diagnosis and treatment planning, as the goal of intervention is to disconnect the fistulous connection and eliminate the abnormal venous drainage that causes cord dysfunction. In some cases, the draining veins may also include the epidural venous plexus, as reported in a case study from 1, highlighting the complexity of venous drainage in SDAVF. Overall, the draining veins in SDAVF play a critical role in the pathophysiology of the disease, and their identification is essential for effective treatment, as emphasized in 2.