Abstract
A 64-year-old man initially presented with dysuria to another institution's department of urology. He developed tetraplegia soon after admission. Neuroradiological examinations revealed a shunting point in the vicinity of the cerebellar tentorium and a dural arteriovenous fistula (dAVF) descending to the surface of the spinal cord.
To the best of our knowledge, there have been no reports of a time lag between urinary retention as the only initial manifestation and the development of other spinal symptoms, although there have been occasional reports on an intracranial dAVF caused by myelopathy associated with urinary retention.
The tracts for urination are usually located in the lateral and dorsal funiculi, and the afferent tract, in particular, is located in the dorsal funiculus. Based on previous reports and from an anatomical standpoint, we speculated the following course in the present case : venous congestion first occurred in the lateral horn, causing a disturbance in the adjacent lateral funiculus, thereby resulting in the development of urinary retention symptoms, which in turn affected the surrounding tissues. Finally, the patient developed tetraplegia.
