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Spinal dAVF – Recovery After Treatment — SCE Neurology MCQ

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HardNeurorehabilitationSpinal dAVF – Recovery After TreatmentSCE Neurology

A 55-year-old man presents with progressive difficulty walking and bilateral leg weakness. He has a spinal dural arteriovenous fistula confirmed by spinal angiography. He underwent successful endovascular embolisation 6 months ago. Despite treatment, he continues to have residual spastic paraparesis and requires a walking stick. What is the expected recovery pattern after dAVF treatment?

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Correct answer: A — Recovery is often incomplete — neurological improvement may continue for months but residual deficits are common, especially if diagnosis was delayed

The best answer is “Recovery is often incomplete — neurological improvement may continue for months but residual deficits are common, especially if diagnosis was delayed”. Rehabilitation is multidisciplinary and goal-directed, with swallowing, communication, mobility, cognition, capacity and participation assessed using practicable supports rather than inferred from physical disability. The alternatives “Complete recovery within days, after specialist assessment, when the phenotype supports it, within the relevant UK pathway, after excluding important mimics”, “No improvement is expected after embolisation, when the phenotype supports it, within the relevant UK pathway, after excluding important mimics”, “Recovery occurs with physiotherapy, not with the procedure, within the relevant UK pathway, after excluding important mimics, after specialist assessment”, “Symptoms worsen after treatment, after excluding important mimics, after specialist assessment, when the phenotype supports it, within the relevant UK pathway” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG236 stroke rehabilitation recommendations: https://www.nice.org.uk/guidance/ng236/chapter/Recommendations