Cerebrospinal fluid cannot be used to distinguish inflammatory myelitis from congestive myelopathy due to spinal dural arteriovenous fistula: case series

Patients with congestive myelopathy due to spinal dural arteriovenous fistula (SDAVF) typically present with progressive sensory and motor disturbance in association with sphincter dysfunction. Spinal MRI usually shows longitudinally extensive T2 signal change. Here, we report four patients with pro...

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Bibliographic Details
Published in:BMJ neurology open 2019-07, Vol.1 (1), p.e000019-e000019
Main Authors: Vivekanandam, Vinojini, Li, Vivien, Wu, Teddy, Dowling, Richard, Roxburgh, Richard H, McGuiness, Ben J, Kilfoyle, Dean H, Manji, Hadi, Quaegebeur, Annelies, Thom, Maria, Robertson, Fergus, Thevathasan, Wesley, Evans, Andrew, Brew, Stefan, Mitchell, Peter
Format: Article
Language:English
Subjects:
Biopsy
Cellular biology
Cerebrospinal fluid
CSF
Edema
Electromyography
Fecal incontinence
Fistula
General anesthesia
Histopathology
Knee
Lymphocytes
Medical imaging
MRI
myelopathy
neuropathology
neuroradiology
Patients
Proteins
Short Report
Spinal cord
Steroids
Urinary retention
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Summary:Patients with congestive myelopathy due to spinal dural arteriovenous fistula (SDAVF) typically present with progressive sensory and motor disturbance in association with sphincter dysfunction. Spinal MRI usually shows longitudinally extensive T2 signal change. Here, we report four patients with progressive myelopathy due to SDAVF who also presented with findings on cerebrospinal fluid (CSF) examination suggestive of an inflammatory aetiology. Such CSF findings in SDAVF are important to recognise, to avoid the erroneous diagnosis of an inflammatory myelitis and inappropriate treatment with immunosuppression. SDAVF can be difficult to detect and may require repeated investigation, with formal angiography as the gold standard.
ISSN:2632-6140
2632-6140
DOI:10.1136/bmjno-2019-000019