A unique presentation of a spinal dural arteriovenous fistula exacerbated by steroids

J Clin Neurosci. 2012 Mar;19(3):466-8. doi: 10.1016/j.jocn.2011.07.027. Epub 2012 Jan 16.

Abstract

Spinal dural arteriovenous fistula (DAVF) is an acquired vascular malformation of the spinal cord that presents as a congestive myelopathy resulting from venous hypertension, edema, and ischemia within the cord. Acute clinical exacerbations have been demonstrated in a variety of clinical settings. We report a unique presentation of a 45-year-old male with progressive paraplegia that acutely worsened following three independent treatments with oral and intravenous steroid administration. Spinal angiogram revealed a spinal DAVF at L3 and the patient underwent successful surgical repair. This report highlights the clinical presentation of spinal DAVF and emphasizes the unique and important potential relationship between steroid administration and clinical deterioration.

Publication types

  • Case Reports

MeSH terms

  • Anaphylaxis / drug therapy
  • Anaphylaxis / etiology
  • Angiography
  • Animals
  • Anti-Inflammatory Agents / adverse effects*
  • Arteriovenous Fistula / chemically induced*
  • Arteriovenous Fistula / pathology*
  • Arteriovenous Fistula / surgery
  • Dura Mater / blood supply
  • Electromyography
  • Food Hypersensitivity / drug therapy
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurologic Examination
  • Paraparesis / chemically induced
  • Paraparesis / etiology
  • Prednisone / adverse effects
  • Prednisone / therapeutic use
  • Seafood / adverse effects
  • Spinal Diseases / chemically induced*
  • Spinal Diseases / pathology*
  • Steroids / adverse effects*
  • Vascular Surgical Procedures

Substances

  • Anti-Inflammatory Agents
  • Steroids
  • Prednisone