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- W2805102301 abstract "Objective: To report a 63-year-old man with a spinal dural arteriovenous fistula (dAVF) and concomitant intramedullary non-vascular spinal lesion. Background: Spinal dAVFs are the most common spinal vascular malformations. Although extremely rare, patients with multiple independent spinal dAVFs have been reported. Moreover, cases of combined dAVF and spinal lipoma as well as dAVF and spinal dysraphism are similarly rare. Occurrence of spinal dAVF and concurrent intramedullary spinal neoplastic lesion has not yet been described, to our knowledge. Design/Methods: Case report. Results: 63-year-old man who presented with a 6-month history of lower back pain followed by progressive bilateral leg weakness/paresthesia and bowel and bladder incontinence. Neuroimaging showed an enhancing C6 intramedullary lesion and diffuse T2 signal abnormality in the thoracic cord as well as vascular flow voids. CSF examination was unremarkable. He received a 5-day course of IV steroids, with minimal symptomatic improvement. Further investigation with spinal angiography revealed a L1 dAVF - subsequently embolized with significant clinical improvement. The cervical lesion was observed with periodic surveillance. Three-month follow-up spinal/cerebral angiography showed no residual vascular lesion or evidence of any vascular malformation in the cervical topography. Six-month follow-up imaging showed that the intramedullary cervical lesion had remained stable. We believe the cervical lesion is highly suspicious for low-grade glioma - based on clinical/imaging features. Therefore, this patient may be the first reported case of spinal dAVF and concomitant intramedullary spinal neoplasm. Conclusions: DAVF is a rare but treatable cause of progressive paraparesis. This condition should be included in the differential diagnoses of patients (especially older men) presenting with progressive symptoms of myelopathy whose imaging studies show an enlarged cord with intramedullary enhancement and T2 hyperintensity along with flow voids along the dorsal aspect of the cord. This report highlights the importance of pursuing a diagnosis of dAVF even in the setting of a concomitant, non-vascular spinal lesion. Disclosure: Dr. Nascimento has nothing to disclose. Dr. Kan has nothing to disclose. Dr. Sharp has nothing to disclose. Dr. Mandel has nothing to disclose." @default.
- W2805102301 created "2018-06-13" @default.
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- W2805102301 date "2018-04-10" @default.
- W2805102301 modified "2023-09-27" @default.
- W2805102301 title "Spinal dural arteriovenous fistula and concomitant intramedullary spinal lesion. (P6.122)" @default.
- W2805102301 hasPublicationYear "2018" @default.
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