MRI OF INTRADURAL SPINAL ARTERIOVENOUS-FISTULA ASSOCIATED WITH ISCHEMIA AND INFARCTION OF THE CORD

This report presents a patient with an intradural spinal arteriovenous fistula complicated by infarction of the cord. The diagnosis of an arteriovenous malformation was made on the magnetic resonance imaging (MRI) study with the demonstration of intraspinal serpentine areas of low signal intensity (flow voids). The presence of other MRI findings believed to represent spinal cord ischemia included multisegmental swelling of the cord associated with T1 and T2 prolongation and gadolinium enhancement. The location of the malformation, as well as arterial supply and venous drainage, were defined on selective spinal arterial digital subtraction angiography (DSA). Following surgical resection, the clinical condition stabilized, but with poor return of lost function. The repeat MRI 6 months after surgery demonstrated diffuse thoracic cord atrophy.