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Abstract - Case Report

J Cerebrovasc Endovasc Neurosurg. 2022 24(4): 398-403
The Journal of Cerebrovascular and Endovascular Neurosurgery
Congestive myelopathy due to spinal dural arteriovenous fistula mimicking CNS demyelinating disease
Nakhoon Kim, Hongil Kim, Hyunkee Kim, Jinseok Park
Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea

Spinal dural arteriovenous fistula (SDAVF) is known for its ambiguous and various clinical presentations. Among these presentations, congestive myelopathy is one of the most common, yet it is challenging to correctly diagnose SDAVF at initial presentation. Several diseases present as myelopathy, including demyelinating diseases. Herein, we present two cases of congestive myelopathy due to SDAVF presenting to the emergency room (ER) with progressive quadriparesis. Even though the patients had a proper magnetic resonance imaging (MRI) examination from the initial presentation, there was a delay in making a final diagnosis. Both patients clinical presentation and MRI mimicked central nervous system (CNS) demyelinating disease initially, and a more thorough examination revealed SDAVF. Such a delay in diagnosis can result in more neurological deterioration and may result in more sequelae. Hence, SDAVF should always be considered as a differential diagnosis when examining patients with myelopathy.
Key words : Dural arteriovenous fistula, Congestive myelopathy, Demyelinating diseases, Neuromyelitis optica, Multiple sclerosis, Quadriplegia

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