Journal of Emergencies, Trauma, and Shock

: 2011  |  Volume : 4  |  Issue : 2  |  Page : 299-

Spinal dural arteriovenous fistula incidentally discovered

Toshikazu Abe1, Yasuharu Tokuda2, Shinichi Ishimatsu3, Gerald H Stein4,  
1 Harvard School of Public Health, MA, USA
2 Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Mito, Japan
3 Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
4 Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA

Correspondence Address:
Toshikazu Abe
Harvard School of Public Health, MA

How to cite this article:
Abe T, Tokuda Y, Ishimatsu S, Stein GH. Spinal dural arteriovenous fistula incidentally discovered.J Emerg Trauma Shock 2011;4:299-299

How to cite this URL:
Abe T, Tokuda Y, Ishimatsu S, Stein GH. Spinal dural arteriovenous fistula incidentally discovered. J Emerg Trauma Shock [serial online] 2011 [cited 2019 Dec 8 ];4:299-299
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Full Text

A 66-year-old man, with a history of sick sinus syndrome with pacemaker implantation 11 years ago, developed an abrupt-onset seizure and lost consciousness for a few minutes. On physical examination, he was alert with normal vital signs. He complained of neuralgia at C3-4 levels. No motor weakness or sensory disturbances were identified. There was no pacemaker failure, no acute coronary syndrome or no subarachnoid hemorrhage. Cervical spine CT myelography showed mass lesion compressing C1-2 spinal cord [Figure 1]. Three-dimensional neck CT angiography also indicated spinal dural arteriovenous fistula (SDAVF) around the atlas-occipital bone articulation [Figure 2]. After a few days of watchful waiting without using steroids, his pain symptoms completely resolved. Three weeks later, endovascular embolization was carried out. The patient has had no recurrence after 1 year.{Figure 1}{Figure 2}

SDAVF myelopathy is irreversible. [1] Although congestion of SDAVF may mimic peripheral neuropathy, we mainly diagnosed his numbness as the muscular stresses from the seizure because of quick recovery. Recently, we incidentally encountered the patients with SDAVF because of advanced imaging. Emergency physician should know the courses of SDAVF.


1Koch C. Spinal dural arteriovenous fistula. Curr Opin Neurol 2006;19:69-75.