We report the clinical and neuroradiological imaging findings of a 26-year-old man who presented with lumbago related to high flow paraspinal osseous epidural arteriovenous fistulas in the thoracic spine. This case was of particular interest because of his exclusive epidural and paraspinal venous drainage and the presence of a prominent dilated venous pouch in the spinal canal. Angiography demonstrated multiple high flow arteriovenous fistulas with an osseous nidus. Transarterial glue embolization was performed by multistage sessions. Clinical symptoms improved dramatically. The unusual features of this case have important implications for therapeutic management.
LasjauniasPBerensteinA, Ter brugge KG: 11 Spinal Arteriovenous malformations. Vol:2 Clinical and Interventional Aspect in Adult. Surgical Neuroangiography. Second edition. Berlin: Springer-Verlag2001: 738–849.
2.
LasjauniasP: 11 Spinal Arteriovenous Shunts. Vascular Diseases in Neonates, Infants and Children: Interventional Neuroradiology Management. Berlin: Springer1997: 531–563.
3.
BaoYHLingF: Classification and therapeutic modalities of spinal vascular malformations in 80 patients. Neurosurgery40: 75–811997.
4.
NiimiYBerensteinAFernandezPM: Pediatric nonvertebral paraspinal arteriovenous fistulas along the segmental nerve:clinical, imaging, and therapeutic considerations. J Neurosurg103: 156–162, 2005.
5.
ShuDCChoiCGSungKB: Spinal Osseous Epidural Arteriovenous Fistula with Multiple Small Arterial Feeders Conversing to a Round Fistular Nidus as a Target of Venous Approach. Am J Neuroradiology25: 69–73, 2004.
6.
HuiFTrosseloMPMeiselHJ: Paraspinal arteriovenous shunts in children. Neuroradiology36: 69–73, 1994.
SilvaNJanelACTallP: Spinal epidural arteriovenous fistulas associated with progressive myelopathy. Report of four cases. J Neurosurg Spine6: 552–8, 2007.
9.
ChaungNAShroffMMWillinskyRA: Slow-Flow Spinal Epidural AVF with Venous Ectasias: Two Pediatric Case Reports. Am J Neuroradiol24: 1901–1905, 2003.
10.
ChenCJHuangCCHsuYY: Small Isolated Paraspinal Arteriovenous Fistula. Am J Neuroradiology18: 359–361, 1997.
11.
CognardCSernaanHBakchineS: Paraspinal arteriovenous fistula with perimedullary venous drainage. Am J Neuroradiol16: 2044–2048, 1995.
12.
MatsumuraATsuboiKHyodoA: Lumbosacral extradural spinal arteriovenous malformation with blood supply from branches of internal iliac arteries. Neurochirurgia29: 235–237, 1986.
13.
HanSSLoveMBSimeoneFA: Diagnosis and treatment of a lumbar extradural arteriovenous malformation. Am J Neuroradiol8: 1129–1130, 1987.
14.
SzajnerMWeilAPiotinM: Endovascular Treatment of a Cervical Paraspinal Arteriovenous Malformation via Arterial and Venous Approaches. Am J Neuroradiol20: 1097–1099, 1999.
15.
GoyalaMWillinskyRMontaneraW: Paraver-tebral Arteriovenous Malformations with Epidural Drainage: Clinical Spectrum, Imaging Features, and Results of Treatment. Am J Neuroradiol20: 749–755, 1999.
16.
BradacGBSimonRSSchrammJ: Cervical epidural AVM: report of a case of uncommon location. Neuroradiology14: 97–100, 1977.
17.
AsaiJHayashiTFujimotoT: Exclusively epidural arteriovenous fistula in the cervical spine with spinal cord symptoms: case report. Neurosurgery48: 1372–5, 2001.
