Decompensation of undiagnosed spinal dural arteriovenous fistulae after lumbar epidural injection and spinal anaesthesia N.C. Owen, L.T. Smith, L. Massey,

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Decompensation of undiagnosed spinal dural arteriovenous fistulae after lumbar epidural injection and spinal anaesthesia N.C. Owen, L.T. Smith, L. Massey, A.J. Durnford, C.E.M. Hillier British Journal of Anaesthesia Volume 107, Issue 1, Pages 109-111 (July 2011) DOI: 10.1093/bja/aer179 Copyright © 2011 The Author(s) Terms and Conditions

Fig 1 (a) Case 1, Sagittal T2 MRI image of the lumbar spine. White arrow demonstrates a central disc prolapse at L3/4 with moderate canal stenosis. (b) Case 1, Sagittal T2 MRI image of the dorsal cord. Black arrow demonstrates extensive intra-axial high signal and cord expansion from T7 to L1, representing extensive myelopathy. Serpiginous low signal structures visible around the cord at T7/8. (c) Case 1, spinal angiogram. White arrow demonstrates enlarged draining vein. SDAVF diagnosed with main supply from T5 segmental vessel. (d) Case 2, Sagittal T2 MRI image of the dorsal lumbar spine. White arrow demonstrates diffusely swollen cord with signal abnormality from T7 to conus. (e) Case 3, MRI whole spine with post-gadolinium sequencing. Evidence of congenital anomaly of cord, with low-lying conus (L5) and diffusely high signal from T9 to L5. Anterior spinal artery significantly dilated in the lumbar region with innumerable abnormal vessels on the dorsal aspect of the spinal cord. Small discrete cyst noted at L3/4, thought to represent the spinal injection site or secondary to background vascular malformation. British Journal of Anaesthesia 2011 107, 109-111DOI: (10.1093/bja/aer179) Copyright © 2011 The Author(s) Terms and Conditions