Thoracic pain and arteriovenous fistula of the spinal cord
Awada, A.; Artigou, J.Y.; Chiras, J.; Marelle, L.; Lascault, G.
Revue Neurologique (Paris) 140(12): 740-743
1984
ISSN/ISBN: 0035-3787 PMID: 6522915 Document Number: 234442
A 58 year old man was admitted with a pseudo-coronary pain. Cardiological investigations (ECG, chest X-ray, enzymes) were normal. Pain however was exacerbated by movement, coughing and pressure over T4 to T10 vertebrae. On the 4th day, the patient developed a weakness of the right lower limb which worsened 15 days later. On examination there were in the right lower limb a combination of central (Babinski sign) and peripheral signs (diminished deep reflexes, loss of sensation to all modalities ipsilateral to the paralysis). Metrizamide myelography was within normal limits. Spinal angiography revealed a dural arteriovenous fistula draining into spinal veins, at the level of T5. Following the removal of the fistula, the pain disappeared and the other symptoms and signs improved.