Embolization therapy has been used as the initial treatment for spinal dural arteriovenous fistula (SDAVF) only for certain patients or in certain medical institutions due to its minimal invasiveness, but the recurrence of embolization remains a clinical challenge. The recurrent patient usually exhibits a gradual onset of symptoms and progressive deterioration of neurological function. Developing paraplegia several hours after embolization is commonly seen in patients with venous thrombosis-related complications, for which anticoagulation therapy is often administered. This article reports on a SDAVF patient who had weakness of both lower extremities before embolization and developed complete paraplegia several hours after embolization therapy, later confirmed by angiography as fistula recurrence. The symptoms were relieved gradually after second embolization. The pathophysiology of this patient is also discussed.
Aged ; Central Nervous System Vascular Malformations ; physiopathology ; therapy ; Embolization, Therapeutic ; methods ; Humans ; Paraplegia ; diagnosis

We report the hemodynamic assessment in a patient with cerebral arteriovenous malformation using time-resolved magnetic resonance angiography (TRMRA), a non-invasive modality, and catheter-based digital subtraction angiography (DSA), before and after embolization. Comparison of the results showed that TR-MRA produced very fast dynamic images and the findings closely matched those obtained at DSA. For initial work-up and follow-up studies in patients with vascular lesions, TR-MRA and DSA are therefore comparable.
Adult ; Angiography, Digital Subtraction ; Case Report ; Cerebrovascular Circulation ; Comparative Study ; *Embolization, Therapeutic ; Follow-Up Studies ; Human ; Intracranial Arteriovenous ; Malformations/diagnosis/physiopathology/*therapy ; *Magnetic Resonance Angiography ; Male ; Support, Non-U.S. Gov't ; Time Factors