ISSN: 1223-1533

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Authors: A. Gogu, Dorina Scutelnicu, H. Pleș, Aura Ignea


Background: A spinal dural arteriovenous fistula (SDAVF) is an abnormal shunt between a spinal radicular artery and corresponding radicular vein that drains the perimedullary venous system.


Methods: Between August 2012 and January 2013 we diagnosticated 3 patients with SDAVF. They were treated by surgery.The diagnosis of SDAVF was confirmed by MR-angiography which reveals “flow- void phenomena”, representing tortuous and dilated veins at the dorsal surface of the spinal cord.


Results: Case 1- A 57-year old female, M.B, acute onset; the symptoms develop within minutes and mimic an anterior artery syndrome: paraplegia, total sensory loss, urinary retention, bowel incontinence.MRA: on T2 weighted sequences the cord edema is depicted as a centromedullary hyperintensity over T7-L1; T2 weighted MRA shows numerous “flow-voids” over the dorsal spinal cord, between T10-L1.

Case 2- A 35-year old female, S.F., subacut onset in two weeks with gait difficulties, asymmetrical paraparesis and sensory symptoms;, first with loss of pain and temperature sensation, ascending to the T6 level; micturition disturbances. MRA: hipointensities on T1-weighted images and hyperintensities on T2-weighted images (spinal cord edema and perimedullary vessels which are dilated and coiled at T6-T11).The technique of first pass gadolinium-enhanced MRA demonstrate the level of the shunt at T6.

Case 3-A 71-year old male, H.I, chronic onset in 3 months presented initial symptoms like difficulty in climbing stairs, gait disturbances, paresthesias and radicular pain witch affect both lower limbs; later the patient was paraplegic with loss of all modalities of skin sensation below T2; urinary retention and constipation. MRA: abnormal blood vessels on either the ventral and the dorsal side of the spinal cord below T2.



  1. Patients develop a progressive myelopathy which at the early stages of the disease often mimics a polyradiculopathy or anterior horn cell disorder.By the time involvement of upper motoneurons or sacral segments makes the diagnosis of SDAVF inescapable, patients suffer from considerable neurological deficits.
  2. Surgical treatment aimed at closure the fistula. Embolization of SDAVF is not possible in our clinics.
  3. Significant subjective improvement was noted in walking and muscle power after surgical treatment.