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CC BY 4.0 · Arq Neuropsiquiatr 2024; 82(09): s00441787760
DOI: 10.1055/s-0044-1787760
Images in Neurology

Acute paraparesis: do not miss Foix-Alajouanine syndrome

Paraparesia crural aguda: a síndrome de Foix-Alajouanine não deve ser desconsiderada
Vitor Maia Arca 
1   Universidade Federal de Pernambuco, Hospital das Clínicas, Departamento de Neurologia, Recife PE, Brazil.
,
Geovane Gomes Silva 
1   Universidade Federal de Pernambuco, Hospital das Clínicas, Departamento de Neurologia, Recife PE, Brazil.
,
Luziany Carvalho Araújo 
2   Universidade Federal de Pernambuco, Empresa Brasileira de Serviços Hospitalares, Hospital das Clínicas, Departamento de Radiologia e Diagnóstico por Imagem, Recife PE, Brazil.
,
Eduardo Sousas de Melo 
3   Universidade Federal de Pernambuco, Centro de Ciências Médicas, Divisão de Neuropsiquiatria, Recife PE, Brazil.
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A 71-year-old male patient presented with sudden loss of strength and hypoesthesia in the lower limbs. A spinal cord magnetic resonance imaging (MRI) scan revealed a vascular tangle in the spinal canal region with hypersignal on T1 in the spinal cord at the T8–T9 level, corresponding with the clinical presentation of the patient ([Figure 1]). Arteriography was performed to study the patient's anatomy and plan further treatment. Dural arteriovenous fistula (DAVF) was confirmed ([Figure 2]).

Zoom
Figure 1 Magnetic resonance imaging (MRI) scans of the thoracic spine: T2-weighted axial (A) and sagittal (B) images showing centromedullary edema (arrow) and prominent serpiginous intradural extramedullary flow voids (arrow); And T1-weighted sagittal postcontrast image (C) depicting enhancement of these vessels (arrow).
Zoom
Figure 2 Spinal angiography showing the site of the spinal dural arteriovenous fistula (arrow). Through a super-selective microcatheterization of the neurodural branch of T11, we found that the same vessel that supplies the dural arteriovenous fistula also gives rise to the anterior spinal artery.

Foix-Alajouanine syndrome (FAS) is a chronic myelopathy with an ischemic lesion in the spinal cord.[1] The classic clinical picture is of a progressive paraparesis; however, acute lower-limb paraparesis could be the initial clinical presentation.[2]


 

Conflict of Interest

The authors have no conflict of interest to declare.

Authors' Contributions

VMA: conceptualization, data curation, formal analysis, investigation, project administration, writing – original draft, writing – review & editing; GGS: conceptualization, data curation, investigation, writing – review & editing; LCA: conceptualization, investigation, project administration, resources, software, supervision, validation, writing – review & editing; ESM: conceptualization, data curation, formal analysis, investigation, methodology, project administration, validation, visualization, writing – review & editing.


  • References

  • 1 Sadighi N, Tajmalzai A, Salahshour F. Spinal arteriovenous malformations causing Foix-Alajouanine syndrome, a case report and review of the literature. Radiol Case Rep 2021; 16 (08) 2187-2191 PMID: 34178190; PMCID: PMC8213980
    CrossrefPubMedSuche in Google Scholar
  • 2 Del Pino-Camposeco J, Villanueva-Castro E, Ponce-Gómez JA, Ramírez-Aragón S, Hernández-Hernández A, Arriada-Mendicoa JN. Foix-Alajouanine Syndrome: A Case Report. Cureus 2023; 15 (03) e36696 PMID: 37113340; PMCID: PMC10128097
    CrossrefPubMedSuche in Google Scholar

Address for correspondence

Vitor Maia Arca

Publikationsverlauf

Eingereicht: 14. Februar 2024

Angenommen: 15. April 2024

Artikel online veröffentlicht:
18. Juli 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Vitor Maia Arca, Geovane Gomes Silva, Luziany Carvalho Araújo, Eduardo Sousas de Melo. Acute paraparesis: do not miss Foix-Alajouanine syndrome. Arq Neuropsiquiatr 2024; 82: s00441787760.
DOI: 10.1055/s-0044-1787760

  • References

  • 1 Sadighi N, Tajmalzai A, Salahshour F. Spinal arteriovenous malformations causing Foix-Alajouanine syndrome, a case report and review of the literature. Radiol Case Rep 2021; 16 (08) 2187-2191 PMID: 34178190; PMCID: PMC8213980
    CrossrefPubMedSuche in Google Scholar
  • 2 Del Pino-Camposeco J, Villanueva-Castro E, Ponce-Gómez JA, Ramírez-Aragón S, Hernández-Hernández A, Arriada-Mendicoa JN. Foix-Alajouanine Syndrome: A Case Report. Cureus 2023; 15 (03) e36696 PMID: 37113340; PMCID: PMC10128097
    CrossrefPubMedSuche in Google Scholar

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Zoom
Figure 1 Magnetic resonance imaging (MRI) scans of the thoracic spine: T2-weighted axial (A) and sagittal (B) images showing centromedullary edema (arrow) and prominent serpiginous intradural extramedullary flow voids (arrow); And T1-weighted sagittal postcontrast image (C) depicting enhancement of these vessels (arrow).
Zoom
Figure 2 Spinal angiography showing the site of the spinal dural arteriovenous fistula (arrow). Through a super-selective microcatheterization of the neurodural branch of T11, we found that the same vessel that supplies the dural arteriovenous fistula also gives rise to the anterior spinal artery.