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Case Reports
. 2014 Feb;55(2):106-9.
doi: 10.3340/jkns.2014.55.2.106. Epub 2014 Feb 28.

Spinal arteriovenous fistula with progressive paraplegia after spinal anaesthesia

Gerasimos Baltsavias  1 , Nikolaos Argyrakis  2 , Georgios K Matis  1 , Stephanie Mpata-Tshibemba  2
Affiliations
Case Reports

Spinal arteriovenous fistula with progressive paraplegia after spinal anaesthesia

Gerasimos Baltsavias et al. J Korean Neurosurg Soc. 2014 Feb.

Abstract

A case of an iatrogenic spinal arteriovenous fistula with progressive paraplegia in a young woman is reported. The fistula was eventually created after repetitive lumbar punctures performed in the process of spinal anaesthesia. Her symptoms were progressed to paraplegia over a period of 2 years. The digital subtraction angiography demonstrated a single-hole fistula, involving the anterior spinal artery and vein. The lesion was occluded by embolization with immediate improvement. The potential mechanism is discussed.

Keywords: Arteriovenous fistula; Iatrogenic lesion; Paraplegia; Spinal anaesthesia.

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Figures

Fig. 1
Fig. 1
Selective angiogram of the left L1 artery showing the site of single-hole shunt between the ASA and vein with the characteristic dilatation.
Fig. 2
Fig. 2
Selective angiogram of the left L1 artery showing the spinal venous congestion induced by the shunt.
Fig. 3
Fig. 3
Post-embolisation selective L1 angiogram showing the occlusion of the shunt.
See this image and copyright information in PMC

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