Myelopathy of rare and treatable cause: a case report
DOI:
https://doi.org/10.32385/rpmgf.v37i6.12916Keywords:
Arteriovenous fistula, Spinal cord vascular diseases, Spinal cord ischemiaAbstract
Introduction: Spinal dural arteriovenous fistulas (FAVDE) are rare and have an unspecific and insidious clinical presentation. Its etiology is unknown and the incidence is higher in middle-aged men.
Case Description: A 50-year-old woman, with a history of reactive depression, went to the family physician for pain after a fall with an impact on her right hip and knees. The physical exam and radiographic images did not show any pathological findings, however, the pain persisted despite the conservative treatment. Lower limb dysesthesia and urinary and fecal incontinence added to the initial symptoms of nocturne right hip pain. The patient was referred to a neurosurgery appointment and a FAVDE was detected.
Comment: The aim of this case report is to show the difficulties found in the evaluation of this patient and raise awareness for this rare pathology, enhancing the importance of a timely diagnosis and treatment.
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Ortega-Suero G, Porta Etessam J, Moreu Gamazo M, Rodríguez-Boto G. Spinal arteriovenous fistulas in adults: management of a series of patients treated at a neurology department. Neurologia. 2018;33(7):438-48.
Derollez C, Tard C, Kazémi A, Vermersch P, Pruvo JP. A rare and treatable cause of medullar claudication: spinal dural arteriovenous fistula. Ochsner J. 2019;19(4):397-400.
Fox S, Hnenny L, Ahmed U, Meguro K, Kelly ME. Spinal dural arteriovenous fistula: a case series and review of imaging findings. Spinal Cord Ser Cases. 2017;3:17024.
Iglesias Gordo J, Martínez García R. Spinal dural arteriovenous fistulas: the most frequent vascular malformations of the spinal cord. Radiologia. 2018;60(3):237-49.
Fugate JE, Lanzino G, Rabinstein AA. Clinical presentation and prognostic factors of spinal dural arteriovenous fistulas: an overview. Neurosurg Focus. 2012;32(5):E17.
Risavi BL, Sekula R, McQuone B, Radachy J. Type I AV fistula of the thoracic spinal cord. Am J Emerg Med. 2019;37(2):375.e5-6.
Jablawi F, Schubert GA, Dafotakis M, Pons-Kühnemann J, Hans FJ, Mull M. Long-term outcome of patients with spinal dural arteriovenous fistula: the dilemma of delayed diagnosis. AJNR Am J Neuroradiol. 2020;41(2):357-63.
Goyal A, Cesare J, Lu VM, Alvi MA, Kerezoudis P, Brinjikji W, et al. Outcomes following surgical versus endovascular treatment of spinal dural arteriovenous fistula: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2019;90(10):1139-46.
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