Spinal Dural Arteriovenous Fistula: A Mimic of Demyelinating Disease and Radiculopathy

Spinal dural arteriovenous fistula (SDAVF) is characterized by an abnormal connection between a radicular artery and the venous plexus producing spinal cord venous congestion. It manifests with nonspecific sensory and motor symptoms. We present three cases of SDAVF with different forms of presentati...

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Published inCurēus (Palo Alto, CA) Vol. 14; no. 4; p. e24134
Main Authors Alfaro-Olivera, María, Otiniano-Sifuentes, Ricardo D, Simbrón-Ribbeck, Lourdes, Zelada-Ríos, Laura, Barrientos-Imán, Danny, Abanto, Carlos, Ramírez-Quiñones, Jorge, Valencia, Ana
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 14.04.2022
Cureus
Subjects
Blood tests
Case reports
Constipation
Disease
Fistula
Magnetic resonance imaging
Medical imaging
Metabolism
Multiple sclerosis
Neurological disorders
Neurology
Pain
Radiology
Spinal cord
Urinary retention
demyelinating disease
radiculopathy
epicone syndrome
multiple sclerosis
spinal dural arteriovenous fistula
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Summary:Spinal dural arteriovenous fistula (SDAVF) is characterized by an abnormal connection between a radicular artery and the venous plexus producing spinal cord venous congestion. It manifests with nonspecific sensory and motor symptoms. We present three cases of SDAVF with different forms of presentation; in two cases, an autoimmune etiology was considered, and in the third case, the initial diagnosis was chronic radiculopathy. In all three cases, a serpentine enhancement was observed after the gadolinium in the dorsal region of the spinal cord corresponded to flow voids in T2-weighted images, which guided the diagnosis. SDAVF should be considered in atypical clinical presentations of radiculopathies or spinal cord syndromes, especially spinal conus or epicone syndrome. Likewise, it should be part of the differential diagnosis of spinal cord presentations of demyelinating diseases such as multiple sclerosis or neuromyelitis optica spectrum disorders.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.24134