Spinal extradural arteriovenous malformation presenting with recurrent hemorrhage and intermittent paraplegia: case report and review of the literature.

Symptomatic spinal extradural arteriovenous malformations (AVMs) are uncommon. They usually present with slowly progressive myelopathy and/or radiculopathy and only rarely with spinal extradural hemorrhage (SEH). Histopathologic features of a true spinal extradural AVM causing an overt SEH have only previously been described in four cases. A further case of a histologically confirmed spinal extradural AVM causing SEH in a 50-year-old otherwise medically normal Caucasian woman is presented. Recurrent hemorrhage resulted in intermittent paraplegia and acute chest/shoulder pain--diagnosed initially as hysteria. Interesting sequential myelographic, computed tomographic, and magnetic resonance imaging studies are presented, and the literature on spinal extradural AVMs presenting with SEH is reviewed.