Spinal dural arteriovenous fistulas (SDAVFs) are rare vascular malformations with unspecific clinical manifestations, which often lead to misdiagnosis and delay in the establishment of effective therapies. Since the neurological prognosis depends on symptom duration and pretreatment neurological status, rapid identification and obliteration of the fistula are key to provide patients with a better quality of life. We herein describe an illustrative case of an elderly patient presenting with progressive myelopathy, with a definitive diagnosis of SDAVF after 18 months of the initial symptoms. We also review the core concepts regarding this condition and discuss strategies to prevent misdiagnosis and worsening of the neurological outcome.

Fístulas arteriovenosas durais espinhais (FADEs) são malformações vasculares raras e com manifestações clínicas pouco específicas, o que frequentemente leva a erros diagnósticos e ao atraso no estabelecimento de terapias efetivas. Considerando que o prognóstico neurológico depende da duração dos sintomas e do status neurológico prévio, a agilidade na identificação e obliteração da fístula são essenciais para prover melhor qualidade de vida aos pacientes. Neste estudo, descrevemos um caso ilustrativo de um paciente idoso com quadro de mielopatia progressiva, com diagnóstico definitivo de FADE após 18 meses do início dos sintomas. Realizamos ainda uma revisão sobre os conceitos principais da doença e discutimos estratégias para prevenir atrasos diagnósticos e piora neurológica.

*Study conducted at the Teaching Hospital of Universidade Estadual de Campinas, Campinas, SP, Brazil.

Received: 01 August 2023

Accepted: 16 May 2024

Article published online:
23 July 2024

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