Spinal dural arteriovenous fistula: a case-based review


  • Gargee M. Pore Department of Neurology, Bharati Hospital and Research Centre, Pune, Maharashtra, India
  • Brig S. P. Gorthi Department of Neurology, Bharati Hospital and Research Centre, Pune, Maharashtra, India




Dural fistula, Paraplegia, Myelopathy


Spinal dural arteriovenous fistula is an abnormal connection between radicular arteries and spinal venous plexus. This condition is relatively rare with annual incidence of five-ten cases per million. We present a case of a 62-year-old male with complaints of tingling in feet since six months and weakness in legs since 1 hour. Lower limb weakness progressed over a day to complete paralysis and bladder incontinence. Magnetic resonance imaging (MRI) spine showed a dural hypointensity over D6-D11 with abnormal vessels around spinal cord. Patient underwent spinal angiography which showed an intramedullary arteriovenous malformation causing compression. Arterial embolization was done within 24 hours from symptom onset and he ambulated within a week. AV malformations are a rare cause of compressive myelopathy presenting with acute paraplegia. Advances in endovascular techniques have made it possible to treat them early and prevent irreversible damage.


Schaat TJ, Salzman KL, Stevens EA. Sacral origin of a spinal dural arteriovenous fistula: case report and review. Spine. 2002;27(8):893-7.

Erdogan C, Hakyemez B, Arat A, Bekar A, Parlak M. Spinal dural arteriovenous fistula in a case with lipomyelodysplasia. Br J Radiol. 2007;80(953):e98-100.

Koch C, Gottschalk S, Giese A. Dural arteriovenous fistula of the lumbar spine presenting with subarachnoid hemorrhage: case report and review of the literature. J Neurosurg Spine. 2004;100(4):385-91.

Criscuolo GR, Oldfield EH, Doppman JL. Reversible acute and subacute myelopathy in patients with dural arteriovenous fistulas: Foix-Alajouanine syndrome reconsidered. J Neurosurg. 1989;70(3):354-9.

Goyal A, Cesare J, Lu VM, Alvi MA, Kerezoudis P, Brinjikji W, et al. Outcomes following surgical versus endovascular treatment of spinal dural arteriovenous fistula: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2019;90(10):1139-46.

Kincaid PK, Duckwiler GR, Gobin YP, Viñuela F. Dural arteriovenous fistula in children: endovascular treatment and outcomes in seven cases. Am J Neuroradiol. 2001;22(6):1217-25.






Case Reports