ABSTRACT
A common origin of the blood supply to a dural arteriovenous malformation and to the spinal cord from the same segmental artery is very rare. This obviously contraindicates embolization of the fistula. Demonstrating the location of the normal spinal blood supply system is therefore mandatory to avoid postoperative complications. The visualization of the normal blood vessels can be masked by a steal phenomenon, but it must at all costs be obtained. The authors describe one such case.
Subject(s)
Arteriovenous Fistula/surgery , Spinal Cord/blood supply , Angiography , Arteriovenous Fistula/diagnostic imaging , Dura Mater/blood supply , Humans , Male , Middle AgedABSTRACT
Occurrence of a renal failure in an infected patient may be referred to various causes: infection, renal toxicity of drugs (for instance aminoglycosides), shock . . . Determination of some urinary enzymatic activities might be helpful in unravelling the mechanism involved in such cases. Therefore a prospective study of the specificity of some urinary enzymatic activities was performed. The whole LDH activity, the LDH isoenzyme 5 (LDH 5), and two lysosomal enzymes, N-acetyl-beta-D-glucosaminidase (NAG) and beta-glucuronidase (beta-GLU) were dosed systematically, in several groups of patients: I (n = 34): healthy control, with normal renal function; II (n = 24): renal impairment, without recent upper urinary-tract infection (UTI) or aminoglycoside treatment; III (n = 27): upper UTI without aminoglycoside treatment, IV (n = 22): patients treated with aminoglycosides (without upper UTI); V (n = 16): upper UTI treated with aminoglycosides. Results showed a rather good specificity of whole LDH and LDH 5 for infectious kidney damage, and of NAG for tubular injury due to aminoglycoside treatments. Values of urinary beta-glucuronidase varied over a wide range; they were little increased in group III, without a great discriminative value. No significant difference was noted between group I and group II, for any enzyme whatever.