Question

Discuss the clinical profile and imaging findings in a patient with spinal dural arterio-venous fistula.

Hint:

MRI and CT myelography are the primary imaging tools used to diagnose spinal dural arterio-venous fistulas.

Answer 1

Step 1: Clinical Profile:
The clinical presentation of spinal dural arterio-venous fistulas (SDAVFs) often includes progressive myelopathy, sensory deficits, and motor weakness. Patients may experience symptoms such as back pain, lower limb weakness, sensory disturbances, and bladder dysfunction. The condition is more common in adult men.

Step 2: Imaging Findings:
MRI and CT myelography are the primary imaging modalities for diagnosing SDAVFs. MRI typically shows an enlarged, tortuous vascular structure along the dural surface, and the contrast-enhanced MRI can reveal the arteriovenous shunt. Angiography confirms the diagnosis by identifying the shunt's arterial feeders and venous drainage.