A Case of Spinal Dural Arteriovenous Fistula Presenting with Unusually Rapid Progression of Symptoms

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Purpose: In spinal dural arteriovenous fistulae (SDAVF), the most common clinical symptoms are gradually progressive gait disturbance, sensory disturbance, or sphincter dysfunction which are caused by venous congestion. We report a patient of SDAVF with acute exacerbation leading to complete paraplegia in 2 days.

Case Presentation: The patient was a 65-year-old female. Complete paraplegia occurred in 2 days. MRI showed the rapid progression of spinal edema. Spinal angiography conducted 3 days after onset confirmed the diagnosis of a SDAVF at the right L1 level, endovascular treatment was performed at the same session. The shunt completely disappeared, and voluntary knee flexion of both sides was possible at 3 hours after treatment. The next day, she was able to raise her legs. After 3 months, the patient could walk without any assistance.

Conclusion: We encountered a case of SDAVF with rapid progression of symptoms. Early recognition of the symptoms and prompt treatment are necessary in this rare clinical setting of SDAVF.