Reversible freezing of gait caused by dural arteriovenous fistula and congestion of the globus pallidus.
BACKGROUND
Freezing of gait (FOG) is defined as an episodic inability to generate effective stepping in the absence of any known cause other than parkinsonism or high-level gait disorders.


METHODS
We present a 59-year-old male with acute, progressive episodes of FOG. Imaging studies revealed a dural arteriovenous fistula (DAVF) associated with edema of the globus pallidus interna (GPi). Cerebral angiography confirmed the diagnosis of DAVF and demonstrated an occluded straight sinus and a retrograde blood flow of deep cerebral veins.


RESULTS
After endovascular closure of the DAVF, a major improvement of FOG was observed concomitant with striking near resolution of GPi congestion.


CONCLUSIONS
This reversal of the clinical course, correlated with changes in imaging studies, suggests a major role of the GPi in the pathology of FOG.
Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel. talsh5@gmail.com
Tal
T
Shahar
Avi
A
Gadoth
Erez
E
Nossek
Nir
N
Giladi
Zvi
Z
Ram
Shimon
S
Maimon
D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000473:pathology*; D002533:Cerebral Angiography; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D005917:Globus Pallidus / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed