ArticleRadiology case reports2025
Progressive quadriparesis in a young woman due to a spinal perimedullary arteriovenous fistula (PMAVF type IVa) successfully treated with endovascular therapy: A case report.
Article in Radiology case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
A perimedullary arteriovenous fistula (PMAVF) is a rare spinal vascular malformation that can lead to progressive neurologic deficits. We report a case of a 23-year-old woman presenting with progressive quadriparesis over 6 months. Initial spinal MRI revealed serpiginous flow voids from the cervical to the lumbar region, indicating abnormal vessels. Subsequent spinal angiography confirmed a PMAVF type IVa arising from the anterior radiculomedullary artery at the tenth thoracal (T10) level, shunting directly into a dilated perimedullary venous system. Transarterial embolization using ethylene-vinyl alcohol copolymer (Onyx) successfully occluded the fistula without compromising normal arterial flow. The patient showed marked neurologic recovery, achieving near-complete motor improvement by the seventh day postprocedure. PMAVF is classified as a type IV spinal vascular malformation and may cause severe neurologic symptoms due to venous hypertension, congestion, or hemorrhage. Early diagnosis is crucial, as endovascular embolization offers a minimally invasive treatment option with a favorable safety profile. This case illustrates the importance of timely recognition and intervention in PMAVF, underscoring the potential for significant functional improvement following endovascular therapy.
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