Paraplegia Following Lumbar Epidural Steroid Injection in a Patient with a Spinal Dural Arteriovenous Fistula

Thiru M. Annaswamy, Jared Worchel

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

We report a patient with a previously undiagnosed spinal dural arteriovenous fistula (SDAVF) who became acutely paraplegic following a lumbar epidural steroid injection for lumbar spinal stenosis. Magnetic resonance imaging showed multiple flow voids and serpentine vessels on the cord surface with cord edema extending from T3 through the conus. Spinal angiography confirmed an SDAVF fed by the left lateral sacral artery, which was subsequently endovascularly embolized, and the patient had a partial return of function. Presence of an undiagnosed SDAVF should be considered in patients presenting with lower-extremity weakness without pain and considered a contraindication to lumbar epidural steroid injection.

Original languageEnglish (US)
Pages (from-to)e147-e150
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume96
Issue number8
DOIs
StatePublished - Aug 1 2017

Keywords

  • Arteriovenous Fistula
  • Case Report
  • Complications
  • Epidural Injections
  • Paraplegia
  • Therapeutic Embolization

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

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