An extremely rare presentation of av fistula: Massive destruction of multiple vertebral bodies with paraparesis.

Title

An extremely rare presentation of av fistula: Massive destruction of multiple vertebral bodies with paraparesis.

Creator

Bansal K; Kalidindi KKV; Gupta A; Surapaneni VN; Kapur R; Chhabra HS

Publisher

Surgical Neurology International

Date

2021
2021-03-30

Description

Background: Spinal ventral epidural arteriovenous fistulas (EDAVFs) are rare and underdiagnosed entities and usually present with benign symptoms such as radiculopathy. To the best of our knowledge, EDAVFs presenting with massive vertebral body destruction have not been reported in the literature. Case Description: A young male presented with mid back pain for 1 year and weakness of both lower limbs for 3 months. He was clinicoradiologically diagnosed with spinal tuberculosis and started on antitubercular treatment elsewhere. Radiological investigations suggested destruction and collapse of T12 and L1 vertebrae. Prominent flow voids were seen in T9-L2 epidural space, likely prominent epidural vessels. The primary differential diagnoses were spinal tuberculosis and neoplastic etiologies. T9 to L3 surgical stabilization and anterior decompression by pediculectomy of left T12 and L was done. The surgeon encountered massive bleeding at the time of anterior decompression and a vascular etiology was suspected. Biopsy revealed negative results for infection or malignancy. DSA revealed ventral EDAVFs, and hence, transcatheter embolization was performed. He had excellent outcome on assessment at 21 months postoperative follow-up. Conclusion: Spinal epidural AVFs can rarely present with gross vertebral body destruction and paraparesis. Preoperative radiological assessment with suspicion of spinal epidural AVFs can help to avoid intraoperative difficulties and complications. Timely, management of spinal epidural AVFs can result in excellent outcomes. [ABSTRACT FROM AUTHOR]

Subject

SYMPTOMS; ARTERIOVENOUS fistula; AV fistula; EPIDURAL abscess; EPIDURAL space; Extradural arteriovenous fistula; FISTULA; Paraparesis; PARAPARESIS; Rare; SPINAL tuberculosis; Vertebral body

Identifier

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

URL Address

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Pages

1-4

Volume

12

ISSN

22295097

NEOMED College

NEOMED College of Medicine Student

NEOMED Department

NEOMED Student Publication

Update Year & Number

April 2021 List

Citation

Bansal K; Kalidindi KKV; Gupta A; Surapaneni VN; Kapur R; Chhabra HS, “An extremely rare presentation of av fistula: Massive destruction of multiple vertebral bodies with paraparesis.,” NEOMED Bibliography Database, accessed July 22, 2024, https://neomed.omeka.net/items/show/11642.