Concurrent spinal dural and intradural arteriovenous fistulas - Case report

Among spinal arteriovenous malformations (AVMs), dural arteriovenous fistul as (DAVFs) should be: distinguished from intradural AVMs. The authors repor t the unusual and well-documented case of a 49-year-old man who suffered fr om a rapidly progressive myelopathy. Two concurrent spinal AVMs (one DAVF a nd one intradural direct AVF [Anson-Spetzler Type IV-B AVM]) were found loc ated in the midthoracic region and in the conus medullaris, respectively. B oth AVMs were successfully treated by surgery. To the authors' knowledge, t he association of these mio pathological entities has not been previously d escribed. Clinically, if the patient fails to improve or deteriorates after the treatment of a spinal AVM, the presence of another AVM should be inves tigated by repeated angiography, especially if a complete spinal angiograph y study was not initially performed.