Case 1. Case 1. Sagittal and axial T2-weighted images demonstrate the dilated venous recipient pouch for fistula 1 as well as dilated veins on the dorsal.

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Presentation transcript:

Case 1. Case 1. Sagittal and axial T2-weighted images demonstrate the dilated venous recipient pouch for fistula 1 as well as dilated veins on the dorsal and ventral aspects of the cord (arrows, A and B). Contrast-enhanced MRA maximum intensity projections demonstrate the large venous recipient pouch of fistula 1 (arrowheads, C and D) and secondary draining veins (arrow, D). Left common iliac artery injection demonstrates a large radiculomedullary artery (curved arrow, E) arising from the left lateral sacral artery (arrow, E) and ascending toward the large venous recipient pouch supplying the fistula (not shown). Microcatheter injection at the level of fistula 1 opacifying the recipient venous pouch (arrow, F) and demonstrating secondary drainage into superiorly (arrowhead, F) and inferiorly (curved arrow, F) draining veins. Native and subtracted images from a right intercostal artery injection (T12) demonstrating the second (2) of the 3 pial fistulas (arrowhead, G) located at the level of inferior endplate of T11. Venous drainage is into a short venous channel (star), draining into a common channel (curved arrow) receiving venous drainage from both smaller fistulas (2 and 3). This common channel then drained into the venous pouch, which was the main recipient venous pouch for the largest fistula (1; arrow, G and H). Selective left T12 injection demonstrates pial fistula 3 (arrowhead, I), also at the level of the inferior endplate of T11. M. Rohany et al. AJNR Am J Neuroradiol 2007;28:584-589 ©2007 by American Society of Neuroradiology