Progressive quadriparesis in a young woman due to a spinal perimedullary arteriovenous fistula (PMAVF type IVa) successfully treated with endovascular therapy: A case report
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| Názov: | Progressive quadriparesis in a young woman due to a spinal perimedullary arteriovenous fistula (PMAVF type IVa) successfully treated with endovascular therapy: A case report |
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| Autori: | Fitri Damayanti, Ashari Bahar, Wijoyo Halim |
| Zdroj: | Radiol Case Rep Radiology Case Reports, Vol 20, Iss 9, Pp 4168-4174 (2025) |
| Informácie o vydavateľovi: | Elsevier BV, 2025. |
| Rok vydania: | 2025 |
| Predmety: | Medical physics. Medical radiology. Nuclear medicine, Transarterial embolization, Myelopathy, Case report, R895-920, Peri-medullary arteriovenous fistula, Case Report, Neurointervention |
| Popis: | A perimedullary arteriovenous fistula (PMAVF) is a rare spinal vascular malformation that can lead to progressive neurologic deficits. We report a case of a 23-year-old woman presenting with progressive quadriparesis over 6 months. Initial spinal MRI revealed serpiginous flow voids from the cervical to the lumbar region, indicating abnormal vessels. Subsequent spinal angiography confirmed a PMAVF type IVa arising from the anterior radiculomedullary artery at the tenth thoracal (T10) level, shunting directly into a dilated perimedullary venous system. Transarterial embolization using ethylene-vinyl alcohol copolymer (Onyx) successfully occluded the fistula without compromising normal arterial flow. The patient showed marked neurologic recovery, achieving near-complete motor improvement by the seventh day postprocedure. PMAVF is classified as a type IV spinal vascular malformation and may cause severe neurologic symptoms due to venous hypertension, congestion, or hemorrhage. Early diagnosis is crucial, as endovascular embolization offers a minimally invasive treatment option with a favorable safety profile. This case illustrates the importance of timely recognition and intervention in PMAVF, underscoring the potential for significant functional improvement following endovascular therapy. |
| Druh dokumentu: | Article Other literature type |
| Jazyk: | English |
| ISSN: | 1930-0433 |
| DOI: | 10.1016/j.radcr.2025.05.027 |
| Prístupová URL adresa: | https://doaj.org/article/f7fbf8a08cb34781b7c5e148b1d7c3eb |
| Rights: | CC BY |
| Prístupové číslo: | edsair.doi.dedup.....cd58dba8431b5abf6ac815b3885eb9c8 |
| Databáza: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | A perimedullary arteriovenous fistula (PMAVF) is a rare spinal vascular malformation that can lead to progressive neurologic deficits. We report a case of a 23-year-old woman presenting with progressive quadriparesis over 6 months. Initial spinal MRI revealed serpiginous flow voids from the cervical to the lumbar region, indicating abnormal vessels. Subsequent spinal angiography confirmed a PMAVF type IVa arising from the anterior radiculomedullary artery at the tenth thoracal (T10) level, shunting directly into a dilated perimedullary venous system. Transarterial embolization using ethylene-vinyl alcohol copolymer (Onyx) successfully occluded the fistula without compromising normal arterial flow. The patient showed marked neurologic recovery, achieving near-complete motor improvement by the seventh day postprocedure. PMAVF is classified as a type IV spinal vascular malformation and may cause severe neurologic symptoms due to venous hypertension, congestion, or hemorrhage. Early diagnosis is crucial, as endovascular embolization offers a minimally invasive treatment option with a favorable safety profile. This case illustrates the importance of timely recognition and intervention in PMAVF, underscoring the potential for significant functional improvement following endovascular therapy. |
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| ISSN: | 19300433 |
| DOI: | 10.1016/j.radcr.2025.05.027 |