A 57-year-old woman with a 3-month history of bilateral lower extremity tingling and progressive lower extremity weakness. A 57-year-old woman with a 3-month.

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Presentation transcript:

A 57-year-old woman with a 3-month history of bilateral lower extremity tingling and progressive lower extremity weakness. A 57-year-old woman with a 3-month history of bilateral lower extremity tingling and progressive lower extremity weakness. A and B, T2-weighted lumbar spine MR images demonstrate high T2 signal in the conus with multiple flow voids in the intradural space. C, T2-weighted MR image of the thoracic spine demonstrates high T2 signal in the lower thoracic cord to the conus. The patient was diagnosed with neuromyelitis optica and received no spinal-vasculature imaging before referral to our institution. Two rounds of IV methylprednisolone (Solu-Medrol) therapy resulted in worsening of symptoms, and rituximab therapy was of no benefit. D, Spinal angiography demonstrates the spinal dural AVF with an arterial feeder from the L3 radiculomeningeal artery. W. Brinjikji et al. AJNR Am J Neuroradiol 2016;37:380-386 ©2016 by American Society of Neuroradiology