title: Spinal dural arteriovenous fistula with hematomyelia caused by intraparenchymal varix of draining vein.
abstract: BACKGROUND
  Hemorrhage that results from spinal dural arteriovenous fistula (Type I arteriovenous malformation [AVM]) is uncommon. There are some reports of subarachnoid hemorrhage and subdural hematoma caused by Type I spinal AVM, but there are few reported cases of hematomyelia caused by spinal dural arteriovenous fistula.
  
  
  OBJECTIVE
  To describe an interesting patient who had hematomyelia caused by a dural arteriovenous fistula (Type I spinal AVM).
  
  
  METHODS
  A case report.
  
  
  METHODS
  We present a case of a 51-year-old man who presented acute onset epigastric pain, paraplegia, and sensory loss below his nipples. Magnetic resonance imaging and selective spinal angiogram demonstrated hematomyelia, subarachnoid hemorrhage, and spinal arteriovenous fistula fed by the right Th7 intercostal artery. By laminotomy of Th6-8, the varix-like draining vein and intramedurally hematoma were partially removed and the arterial supply was interrupted by coagulation of the right Th7 segmental artery.
  
  
  RESULTS
  One month after surgery, he regained movement against gravity at the left ankle and toe but no functionally significant improvement.
  
  
  CONCLUSIONS
  It must be kept in mind that spinal dural arteriovenous fistulas (Type I spinal AVM) has possibility of hematomyelia origin, despite the fact that it is extremely rare.
authors.affiliation: Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Shizuoka, Japan. heisei.ikyoku03@ny.tokai.or.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Minami
authors.forename: Junya
authors.initials: J
authors.lastname: Hanakita
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitahama
authors.forename: Shinji
authors.initials: S
authors.lastname: Onoue
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kino
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ito
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ezaki