We report a case of a 68-year-old woman with an acute paraplegia due to venous congestion of the spinal cord caused by an exclusive epidural arteriovenous fistula. Diagnosed by MRI and selective spinal angiography the fistula was embolized during emergency treatment via transarterial access. Immediately after the intervention the paraplegia declined and the patient recovered completely. Epidural AV fistulae are a very rare and therefore relatively unknown cause of vascular myelopathy. They may require emergency management to avoid permanent neurological deficits.
AsaiJHayashiT: Exclusively epidural arteriovenous fistula in the cervical spine with spinal cord symptoms: Case report. Neurosurgery48(6): 1372–5, 2001.
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BodeMKIsokangasJM: Spinal epidural arteriovenous fistula, a rare course of paraparesis. Duodecim120(9): 1091–1096, 2004.
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SuhChul DChoiGon C: Spinal osseous epidural arteriovenous fistula with multiple small arterial feeders converging to a round fistular nidus as a target of venous approach. Am J Neuroradiol25(1): 69–73, 2004.
