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 ]).
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).
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 ]
Bibliographical Record
