Associations and Outcomes Between Essential Hypertension and Spinal Dural Arteriovenous Fistula in Neuro-surgical Adult Patients: A Mini-Review

This report aims to examine the effects of hypertension associated with Spinal Dural Arteriovenous Fistula (SDAF) in adult patients. The study specifically examined the various studies which address hypertension and its clinical correlation between SDAF. It digs out data on the population variable, initial signs, and symptoms that are associated with the disease progression. According to the analysis of this survey, the victims were mostly middle-aged men. In numer-ous cases, hypertension was associated with SDAF was found in the mid-thoracic region. This study aims to bring to the attention of neurosurgeons the association between hypertension and SDAF. This study has proved that there is a close correlation between the progression of hypertension and SDAF.


Method
This research method was adopted by reviewing medical journals written and analyzed the sources about SDAF. The information gathered from healthcare journals was sorted out to develop a proper understanding of SDAF. Medical journals from the PubMed database were queried with keywords like spinal dural arteriovenous fistula, hypertension, and arteriovenous fistula. The results of the search were sorted out to build a complete understanding of the subject matter under discussion.

Results
Of the 80 patients that were studied, it was found out that 66 of them were men representing 83% [4]. Besides, the average age of the period of the initial symptom was 57.6 years [1,2,4]. From the whole population, only a single patient was below the age of 30 [4]. At the time of their judgment, the median age of the patient was 60.1 years [4,[10][11][12]. According to the study, it is evident that SDAF primarily affects men at the age of 50 years. Most of the patients were above50 years at the time of diagnosis of the disease [4,[13][14][15]. The most striking finding in our study was that; patients were often associated with hypertension because the veins of such individuals have been compromised by various factors of the disease [16].

Pathophysiology& diagnosis of SDAF
SDAF is a condition that is acquired; the exact cause and etiology remain unknown. The Arteriovenous (AV) shunt is usually positioned inside the dural mater near by the spinal nerve roots where the arterial plasma from the artery that supplies the nerve root and the meninges are located [8,16]. This is why the condition is normally associated with hypertension among the patients and also affects mostly those above the age of 50 [8,17,18]. The increase in spinal venous pressure results in diminishing arterialization of the AV pressure gradient. It often results in the decrease in pressure of the spinal veins and the conventional outflow of the venous fluid [5,8,13].

Genetics
There is little information that links SDAF to genetics. However, it is believed that changes in the disorder occurring in the same lineage are more prominent compared to an individual who has never had a history of the disease.

Clinical implication
The initial symptoms are venous congestion, which is non-specific and includes difficulty in climbing stairs, gait disturbance, and

Scientific Analysis
In conducting this research, the two major article which was included, the Ying Jeng et al. and Sato. However, the first article by Ying Jenget at al. was considerably more rewarding and appropriate for the study. This is due to the fact it was more detailed and had a lot of information which informed this study the most. Even though the second article was also very essential for the study, the first one did tell much of the study element with clearly articulated research and in-depth analysis of the survey [32,33].
Spinal Dural Arteriovenous Fistulas (SDAFs) may occur anywhere there is a dural or meningeal covering around the brain or spinal cord. Clinical manifestations include venous hypertension, non-disabling tinnitus to focal neurological deficits, seizures, hydrocephalus, psychiatric disturbances, and developmental delay in the pediatric patient. SDAF is an uncommon but curable sequel that needs emergent treatment, or else advanced paraplegia ensues. Then euro radiologic stage is vital for the discovery of these lacerations