PMC8429830_01
Timeline of the current case.
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F1
The whole timeline of the current case is depicted in Figure 1.
(A) T2-weighted MRI study showing prominent signal void with redundant venous tortuosity, which represents spinal arteriovenous fistula. (B) T2-weighted MRI study showing worsening of spinal cord signal change. (C) T2-weighted MRI study at post-operative 1 month showing decreased cord signal change and disappearance of the signal void with redundant venous tortuosity. (D) T2-weighted MRI study at post-operative 1 year no abnormal cord signal change.
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F2
Initial MRI study from another hospital showed cord signal change and redundant intradural venous tortuosity, which were typical findings of SDAVF (Figure 2A). MRI study showed worsening of cord signal change compared with the initial exam (Figure 2B). Follow-up MRI showed improvement in cord signal change (Figure 2C). MRI performed at 1-year follow-up showed no abnormal cord edema or abnormality (Figure 2D).
Angiogram (A) of the right T12 segmental artery and three-dimensional (3D) reconstructed image (B) demonstrating the main arterial feeder of the radiculomengingeal artery (white arrowhead) arising from the right T12 segmental artery (gray arrow) connected to the engorged perimedullary vein (white arrow).
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F3
T12-L1 forming fistula near neural foramen and engorgement of perimedullary vein running vertically (Figure 3). The intervention team was unable to schedule an emergency procedure, so we chose surgical treatment.
Intraoperative finding revealing intradural arteriovenous fistula.
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F4
SDAVF was found and obliterated with a bipolar coagulation unit (Figure 4).