Spinal dural arteriovenous fistula

Case contributed by Dr Utkarsh Kabra

Presentation

Pain, weakness in bilateral lower limbs and urinary incontinence.

Patient Data

Age: 60 years
Gender: Male

Intramedullary hyperintensity with edema and mild expansion of cord extending from D5 level to conus. 

Associated prominent vascular flow voids are seen in the dural sac, predominantly posteriorly. Areas of subtle T2 hypointensity is seen along the surface of cord – possibly representing pial capillaries containing deoxyhemoglobin secondary to venous hypertension.  

Post-contrast study shows serpentine enhancement of these vessels. No obvious intramedullary enhancement is seen. 

No significant disc bulge/ neural compression seen in dorsal spine. 

Degenerative spondylitis changes seen in lumbar and dorsal spine.

Case Discussion

Overall above findings are suggestive of spinal dural AV fistula with cord edema as described. 

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Case information

rID: 72936
Published: 19th Dec 2019
Last edited: 20th Dec 2019
System: Vascular, Spine
Inclusion in quiz mode: Included

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