Primary conus medullaris arteriovenous shunt and secondary lumbo-sacral epidural arteriovenous fistula:one malformation can hide another

We report an anatomical-based association between conus medullaris pial arteriovenous shunt that drain caudally towards the lumbosacral area with very delayed onset of an acquired lumbar epidural shunt, draining secondarily towards intradural veins and responsible for a venous congestive myelopathy with identical clinical symptoms.These patients require close clinical and imaging follow-ups in order to propose adequate treatments before onset of irreversible neurological deficits. MRA should include the lumbo-sacral area in its field of view.

Source: Journal of Neuroradiology - July 17, 2019 Category: Radiology Source Type: research