Conclusion
This case demonstrates how MRI can misread rare spinal vascular
disorders. So we should be vigilant about spinal vascular diseases and
conduct DSA when appropriate.
Patient Perspective:
The patient had anxiety before surgery, and there was only a slight
improvement in her symptoms after surgery, and she was satisfied with
the treatment and care she received.
Consent: Written informed consent was obtained from the patient’s
daughter to publish the case report and the accompanying images.
References
1. Takai K. Spinal Arteriovenous Shunts: Angioarchitecture and
Historical Changes in Classification. Neurol Med Chir (Tokyo). 2017 Jul
15;57(7):356–65.
2. Spetzler RF, Detwiler PW, Riina HA, Porter RW. Modified
classification of spinal cord vascular lesions. J Neurosurg. 2002
Mar;96(2 Suppl):145–56.
3. Antonietti, L. Long-Term Outcome in the Repair of Spinal Cord
Perimedullary Arteriovenous Fistulas | American Journal of
Neuroradiology [Internet]. [cited 2021 Jul 23]. Available from:
http://www.ajnr.org/content/31/10/1824
4. Gross BA, Du R. Spinal pial (type IV) arteriovenous fistulae: a
systematic pooled analysis of demographics, hemorrhage risk, and
treatment results. Neurosurgery. 2013 Jul;73(1):141–51; discussion 151.
5. Krings T, Lasjaunias PL, Hans FJ, Mull M, Nijenhuis RJ, Alvarez H, et
al. Imaging in spinal vascular disease. Neuroimaging Clin N Am. 2007
Feb;17(1):57–72.
6. El Mekabaty A, Pardo CA, Gailloud P. The yield of initial
conventional MRI in 115 cases of angiographically confirmed spinal
vascular malformations. J Neurol. 2017 Apr 1;264(4):733–9.
7. Marshman LAG, David KM, Chawda SJ. Lumbar extradural arteriovenous
malformation: case report and literature review. Spine J Off J North Am
Spine Soc. 2007 Jun;7(3):374–9.
8. Suntharalingam S, Ringelstein A, Forsting M, Sure U, van de Nes J,
Gembruch O. Completely extradural intraspinal arteriovenous malformation
in the lumbar spine: a case report. J Med Case Reports. 2014 Jun
23;8(1):216.
9. ENDO T, ENDO H, SATO K, MATSUMOTO Y, TOMINAGA T. Surgical and
Endovascular Treatment for Spinal Arteriovenous Malformations. Neurol
Med Chir (Tokyo). 2016 Aug;56(8):457–64.
10. Mourier KL, Gobin YP, George B, Lot G, Merland JJ. Intradural
perimedullary arteriovenous fistulae: results of surgical and
endovascular treatment in a series of 35 cases. Neurosurgery. 1993
Jun;32(6):885–91; discussion 891.