Intracranial dural arteriovenous fistula mistaken as cervical transverse myelitis

Pract Neurol. 2019 Jun;19(3):264-267. doi: 10.1136/practneurol-2018-002091. Epub 2018 Dec 5.


We describe a man with an intracranial dural arteriovenous fistula that presented as a subacute longitudinally extensive cervical myelopathy. The uncommon location of the fistula and the absence of specific radiological signs resulted in initial misdiagnosis as longitudinally extensive transverse myelitis. Neurologists should have a high index of suspicion for dural arteriovenous fistula in older men, especially those with subacute or chronic symptoms, acellular cerebrospinal fluid and, particularly, if there is neurological deterioration soon after corticosteroid treatment. Patients need early angiography to identify this treatable cause of myelopathy.

Keywords: dural fistula; myelitis; myelopathy.

Publication types

  • Case Reports

MeSH terms

  • Arteriovenous Fistula / complications
  • Arteriovenous Fistula / diagnosis
  • Arteriovenous Fistula / pathology
  • Central Nervous System Vascular Malformations / diagnosis
  • Central Nervous System Vascular Malformations / pathology*
  • Cerebral Angiography / methods
  • Diagnosis, Differential
  • Dura Mater / pathology*
  • Humans
  • Male
  • Middle Aged
  • Myelitis, Transverse / complications
  • Myelitis, Transverse / diagnosis
  • Myelitis, Transverse / pathology*
  • Spinal Cord Diseases / diagnosis
  • Spinal Cord Diseases / etiology
  • Spinal Cord Diseases / pathology*