title: Spinal Dural Arteriovenous Fistulas with Segmental Arterial Supply Also Giving Rise to a Radiculomedullary Artery: A Case Report and Review of the Literature.
abstract: BACKGROUND
  During the past 3 decades, a handful of spinal dural arteriovenous fistula cases have been reported in which the segmental artery giving rise to the fistulous connection also supplies a radiculomedullary artery that contributes to the anterior spinal artery.
  
  
  METHODS
  Here, we describe the case of a 62-year-old woman who developed spinal cord and conus medullaris dysfunction over the course of a year attributable to a spinal dural arteriovenous fistula supplied by an L1 radicular artery that also contributed to the anterior spinal artery. Despite rapid deterioration in the weeks leading up to presentation, microsurgical disconnection led to a notable improvement in motor symptoms. We present the details of our case and review the literature regarding this anatomic variant.
  
  
  CONCLUSIONS
  Recognizing this likely rare anatomical variant is critical in optimizing functional outcome.
authors.affiliation: Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Muhamed
authors.initials: M
authors.lastname: Hadzipasic
authors.affiliation: Yale Department of Neurosurgery, Neurovascular and Spine Sections, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Grant
authors.affiliation: Yale Department of Neurosurgery, Neurovascular and Spine Sections, Yale University School of Medicine, New Haven, Connecticut, USA; Yale Department of Radiology and Biomedical Imaging and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Johnson
authors.affiliation: Yale Department of Neurosurgery, Neurovascular and Spine Sections, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Yale Department of Neurosurgery, Neurovascular and Spine Sections, Yale University School of Medicine, New Haven, Connecticut, USA. Electronic address: ketan.bulsara@yale.edu.
authors.forename: Ketan R
authors.initials: KR
authors.lastname: Bulsara
mesh_terms: D001158:Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008526:Medulla Oblongata / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D013116:Spinal Cord / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Adamkiewicz; Anterior spinal artery; Radiculomedullary artery; Spinal AVM; Type I dAVF