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Spinal Dural Arteriovenous Fistula — SCE Neurology MCQ

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HardMultiple Sclerosis & CNS InflammationSpinal Dural Arteriovenous FistulaSCE Neurology

A 42-year-old man presents with sudden onset bilateral leg weakness and urinary retention after a thunderclap headache. MRI spine shows a longitudinally extensive T2 lesion T4–T10 with haemorrhage. Spinal angiogram reveals an AV fistula at T6. What is the diagnosis?

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Correct answer: E — Spinal dural arteriovenous fistula

Spinal dural AVFs cause venous congestion with progressive myelopathy. MRI shows longitudinally extensive cord signal change with flow voids. Spinal angiography is diagnostic. Treatment is embolisation or surgical ligation. A: Infarction would not show a fistula. C: Transverse myelitis lacks vascular features. D: NMOSD is a differential requiring AQP4 testing. E: Epidural haematoma compresses externally.

Reference: ABN Spinal Vascular Malformation Guidelines