Dural arteriovenous fistula causing progressive myelopathy: Limited drainage to the perimedullary veins of the cervical area alone

Intracranial dural arteriovenous fistulas (DAVFs) are uncommon cerebrovascular malformations that usually drain into a sinus or cortical veins. Depending on the pattern of the venous drainage, various clinical symptoms can be present, and most of them are ocular and/or intracranial symptoms, such as cranial nerve paralysis, intracerebral hemorrhage(ICH), subarachnoid hemorrhage (SAH), and intracranial hypertension. DAVFs that drain from a cortical to a perimedullary vein and show venous congestion that results in progressive myelopathy are extremely rare lesions. These symptoms are most commonly associated with an abnormal drainage pattern of Adamkiewicz's artery or when the venous drainage descends toward the thoracolumbar level. We report a case of DAVFs with drainage limited to the cerebellar and perimedullary veins of the cervical area causing progressive myelopathy.