Triple spinal dural arteriovenous fistula.

Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal vascular malformations. Multiple SDAVFs are unusual and can occur either synchronously or metachronously, as reported in the literature. We report on the unusual case of a woman with three separate SDAVFs, which were surgically treated within the same setting; the postoperative course was characterised by unexplained repeated haematoma formation within the surgical sites. A review of the literature was performed to assess the outcomes of patients with multiple distinct SDAVFs: the data of 19 patients were collected, accounting for 41 SDAVFs. Of these, only two patients had all the SDAVFs treated within the same surgical procedure. Based on our literature review, contemporary surgery is not a predisposing factor to haemorrhage per se; however, we can hypothesise that the uncontrolled deliquoration could account for haematoma formation within the surgical sites.