Common origin of the artery of adamkiewicz and a posterior spinal artery with a spinal dural arteriovenous fistula: a case report

Progressive nature of the myelopathy seen in patients with dural arteriovenous fistulas call for timely diagnosis and surgical intervention to alleviate symptoms of neurologic dysfunction. We present a case report of a 51-year-old male presented with progressive sensory and motor deficits, along with gait instability associated with urinary incontinence for a period of one year. MRI of the spine demonstrated a thoracic spinal dural arteriovenous fistula. Spinal angiography showed at T7 on the left a common origin of the artery of adamkiewicz, a posterior spinal artery and the spinal dural arteriovenous fistula. The fistula was surgically treated and the patient made an almost complete recovery. To the author's knowledge, this is the first time that this common origin, of the three vessels, is described in the literature.