Background:
Spinal cord arteriovenous malformations (AVMs) comprise about 3%-4% of primary intraspinal masses and are only rarely found external to the C2-C7 cervical vertebral foramen.
Case description:
A 21-year-old female presented with neck pain and a spastic quadriparesis of 1 year duration. The cervical magnetic resonance imaging and three-dimensional computed tomography angiograms documented an AVM/dural arteriovenous fistula on the right fed by multiple arteries located in the C5-C6 and C6-C7 foramen intervertebralis; utilizing a laminectomy, the large feeding arteries were double-clipped. This allowed for devascularization of the AVM and facilitated resection while preserving the aberrant vertebral artery. The patient was discharged within 1 week and, 2 months later, was able to ambulate to the outpatient clinic.
Conclusion:
Double clipping of the two main right-sided arterial feeders at the C5-C6 and C6-C7 levels allowed for devascularization and resection of this large cervical AVM while carefully preserving the aberrant vertebral artery.