Neurointervention.  2020 Nov;15(3):140-143. 10.5469/neuroint.2020.00192.

Syringomyelia Associated with Spinal Dural Arteriovenous Fistula: Clinical and Radiological Improvement after Embolization

• Singh R
• Deshmukh N
• Lalla R
• Khadilkar S

• KMID: 2508066
• DOI: http://doi.org/10.5469/neuroint.2020.00192

Abstract

Spinal dural arteriovenous fistulae (AVF) are rare and can result in spinal cord dysfunction. We present one such case wherein the patient presented with a venous congestive myelopathy. Magnetic resonance imaging showed a syrinx formation, spinal cord edema, and flow voids. Digital subtraction angiography confirmed the dural AVF, which was treated with embolization. The syrinx disappeared, other spinal cord changes improved, and the patient had remarkable clinical improvement. The case is presented to draw attention to the rare formation of a syrinx in a spinal dural arteriovenous fistula and its disappearance after successful embolization.

Keyword

Spinal dural arteriovenous fistula; Syringomyelia; Embolization; Spinal cord edema; Flow voids

Figure

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  Fig. 1. Pre embolization status showing (A) T2-weighted axial section of cord at T6/T7 level showing syrinx (arrow), (B) T2 weighted sagittal section of spinal cord showing syrinx from upper border of T6 to T8 (arrow) and hyperintense signal from T7 to L1 with flow-voids from T10 to T12 (arrowheads), (C) DSA at L2 level showing dural AV fistula (arrow) with draining vein reaching up to thoracic level. DSA, digital subtraction angiography; AV, arteriovenous.

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  Fig. 2. Post embolization status showing (A) T2 weighted axial image of cord at T6 level showing reduction in syrinx size (arrow), (B) T2 weighted sagittal cord image showing reduction in hyperintense signal, syrinx size (arrow), and disappearance of flow voids, (C) DSA at L2 level showing successful embolization of dural AV fistula (arrow), (D) Onyx cast post embolization of fistula (arrow). DSA, digital subtraction angiography; AV, arteriovenous.

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