Spinal dural arteriovenous malformations--a treatable cause of progressive paraparesis in elderly people.

Spinal dural arteriovenous malformations (SDAVMs) were first described in 1977. They present with a progressive paraparesis, principally in men aged 60 years and over. They are usually dorsolumbar in situation and are thought to be acquired lesions which produce symptoms by obstructing the venous drainage of the spinal cord. There are no pathognomonic clinical features and diagnosis depends on a high level of clinical suspicion and myelography extended into the dorsal region. The condition is probably underdiagnosed and may be quite a common cause of progressive leg weakness in elderly people. Surgical treatment is relatively simple, safe, and if carried at an early stage can lead to dramatic neurological recovery. This paper reports nine cases seen over a period of 7 years. All the patients showed marked neurological improvement after surgery.