Section of Interventional & NeuroradiologyGGMC & Sir JJ Hospital, Byculla, Mumbai

Dr. Prashant Pote (JR2)Dr. Avinash Gutte (Asst. Prof)

26 yrs/M---- From Neurology C/o gradual but rapidly progressive quadreparesis since 3 weeks.C/o Decreased respiratory drive since 2 days.No past major illness.

MRI T2 images showing cord swelling central hyperintensity taking the shape of the central grey matter

After contrast injestion, dilated enhanced perimedullary veins were observed on the surface of the spinal cord

MRI interpretation…DDxSPINAL DAFINTRAMEDULARY AVMINTRAMEDULLARY AVFFORAMNEG MAGNUM DAFPARA-SPINAL AVM

ASA

Final diagnosis Intracranial DAVF fed by

meningohypophyseal trunk and MMA with spinal perimedullary venous drainage.

Treatment option:Occlusion of fistula with liquid embolic

agent(Onyx).

References: Doppman J L, G Di Chiro and E H Oldfield. “Origin of spinal

arteriovenous malformation and normal cord vasculature from a common segmental artery: angiographic and therapeutic considerations..” Radiology 154, no. 3 (March 1985): 687-689

Minami S, T Sagoh, K Nishimura et al. “Spinal arteriovenous malformation: MR imaging..” Radiology 169, no. 1 (October 1988): 109-115. doi:VL - 169.

Mullan S. Reflections upon the nature and management of intracranial and intraspinal vascular malformations and fistulae. J Neurosurg. 1994;80:606–616.[PubMed]

Teng MM, Chang T, Lirng JF et-al. Spinal dural arteriovenous anomalies. J Vasc Interv Radiol. 1992;3 (2): 329-36

Thank you!