Spinal dural arteriovenous fistula

Case contributed by Frank Gaillard
Diagnosis certain


Painful gradual onset Brown-Sequard syndrome.

Patient Data

Age: 60 years
Gender: Female

The lower half of the thoracic cord demonstrates extensive central cord high T2 signal. On the dorsal surface of the cord numerous flow voids are noted. 

Selective injection of the left T6 intercostal demonstrates an arteriovenous fistula with in the T6/7 foramen with draining inferiorly along enlarged pial veins. 

Case Discussion

Typical appearances of a spinal dAVF. The clinical presentation is typically insidious and non-specific and the diagnosis is often not made for quite some time. Cord edema and sometimes enhancement should not be mistaken for a spinal cord tumor. 

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