Msheik Ali, Al Mokdad Zeinab, Gerges Teddy, Aoude Ahmad
Neurological Surgery, Lebanese University Faculty of Medical Sciences, Hadath, LBN.
Public Health, Lebanese University Faculty of Medical Sciences, Hadath, LBN.
Cureus. 2023 May 2;15(5):e38448. doi: 10.7759/cureus.38448. eCollection 2023 May.
Spinal Dural Arteriovenous Fistula (SDAVF) is a rare and complex vascular condition with significant neurological consequences if left untreated. We present a case of SDAVF in a 46-year-old male who presented with progressive myelopathy. The patient presented with a three-month history of progressive lower extremity weakness, numbness, urinary retention, constipation, and gait disturbance. The spine's magnetic resonance imaging (MRI) showed diffuse T2 hyperintensity and contrast enhancement from T11 to L1, raising the suspicion of an intradural spinal cord lesion. Further evaluation with spinal angiography revealed an SDAVF at the level of T11-T12. The patient underwent surgical resection of the fistula, His lower extremity weakness and numbness improved significantly after surgery, and he was discharged with a plan for close follow-up. Early diagnosis and appropriate treatment prevent neurological deficits and improve patient outcomes. Surgical resection of the fistula can significantly improve neurological symptoms and should be considered a treatment option for SDAVF.
脊髓硬脊膜动静脉瘘(SDAVF)是一种罕见且复杂的血管疾病,如果不进行治疗会产生严重的神经后果。我们报告一例46岁男性的SDAVF病例,该患者表现为进行性脊髓病。患者有三个月进行性下肢无力、麻木、尿潴留、便秘和步态障碍的病史。脊柱磁共振成像(MRI)显示从T11到L1弥漫性T2高信号和强化,怀疑存在硬脊膜内脊髓病变。进一步的脊髓血管造影评估显示在T11 - T12水平存在SDAVF。患者接受了瘘管的手术切除,术后其下肢无力和麻木明显改善,出院时计划进行密切随访。早期诊断和适当治疗可预防神经功能缺损并改善患者预后。瘘管的手术切除可显著改善神经症状,应被视为SDAVF的一种治疗选择。