Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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December 10, 2007
Spinal Arteriovenous Fistula
- Lesion supplied by dural branches arising from intercostal, lumbar or sacral arteries and drained by perimedullary veins (ascending or descending)
- Nidus is in dura covering proximal nerve root.
- Most (98-99%) are single lesions; double lesions in 1-2% of patients.
- Clinically: middle-aged or elderly men, slowly progressive and ascending myelopathy due to cord edema (sometimes called: Foix Alajouanine syndrome)
- Contrast enhancement in cord is common.
- Treatment: occlusion of draining veins by endovascular or surgical means
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