Spinal dural arteriovenös fistel - ovanlig, botbar orsak till paraplegi. Tidig diagnos och behandling kan ge total symtomregress
Sammanfattning
Spinal dural arteriovenous fistulae may cause venous congestion in the medulla spinalis with progressive thoracic-lumbar myelopathy. The clinical diagnosis may be delayed due to the unspecific insidious onset with slowly progressive sensory loss in the lower extremities and the perineum, followed by motor disturbances. Untreated the condition usually progresses to paraplegia, bladder paresis and sphincter dysfunction. The disease may progress for years and is probably not always recognized. Diagnosis is by MRI and is verified with spinal angiography. Early diagnosis and treatment is decisive for the outcome.