An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS)

Search Article
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Advertise Subscribe Contacts Login  Facebook Tweeter
  Users Online: 157 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Ahead of Print

Spontaneous spinal osseous epidural arteriovenous fistula with long segments of prominent epidural venous drainage causing severe compressive thoracic myelopathy successfully treated with combined endovascular and surgical treatments: A case report and review of the literature

1 Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand
2 Department of Neuroradiology, Prasat Neurological Institute, Bangkok, Thailand
3 Department of Pathology, Prasat Neurological Institute, Bangkok, Thailand
4 Department of Radiology, Bumrungrad International Hospital, Bangkok, Thailand

Correspondence Address:
Prasert Iampreechakul,
312 Rachawithi Road, Khwaeng Thung Phaya Thai, Bangkok 10400
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_353_20

The authors describe an extremely rare case of spinal osseous epidural arteriovenous fistulas (SOEAVFs) with unique characteristic features. A 25-year-old man presented with progressive weakness and paresthesia of the lower extremities for 1 month. Magnetic resonance imaging of the thoracic spine showed an extradural dilated vascular flow void structure extending from T4 to T8 levels with abnormal hyperintense T2 signal from T6 to T8 levels. Magnetic resonance angiography and spinal angiography revealed unique features of SOEAVF supplied by multiple small arterial feeders of intercostal arteries converging into a dilated round venous sac corresponding to a bony defect of T7 lamina and spinous process. The venous drainage directly drained into prominent epidural venous plexus extending from the level of T4 to T8 without intradural venous drainage, causing severe compressive myelopathy. Transarterial embolization was performed using N-butyl cyanoacrylate through the main feeder. Subsequently, he successfully underwent laminectomy and total excision of the fistula and large epidural draining venous plexus. Histopathology confirmed spinal vascular malformations with evidence of previous embolization. He gradually improved until being ability to walk independently 3 months later. Follow-up spinal angiography confirmed complete resection of SOEAVF. The patient has remained clinically asymptomatic 5 years after operation.

Print this article
  Search Pubmed for
    -  Iampreechakul P
    -  Tirakotai W
    -  Lertbutsayanukul P
    -  Thammachantha S
    -  Siriwimonmas S
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded5    

Recommend this journal