Salient features in the management of sacral spinal dural arteriovenous fistulas

Abstract Background Sacral spinal dural arteriovenous fistulas can present in a variety of ways and it is very important to have a high clinical suspicion to aid prompt diagnosis and subsequent management. The case report highlights the important decision making steps in obtaining the diagnosis and ascertaining the key/salient factors that will help in the treatment of this spinal vascular lesion. Case description We present a case of a 74 year old male with a three-month history of mid thoracic back pain, bilateral lower limb paresthesia and gait disturbance and was subsequently diagnosed with an S1 SDAVF. In addition to the clinical presentation and pathophysiology, we aim to highlight a systematic approach in diagnosing this condition and identify keys factors that will affect follow-up. Conclusion The presented sacral SDAVF case is unique as the patient presented with thoracic pain, mild lower limb weakness and sensory changes. Thorough knowledge regarding sacral SDAVFs will enable clinicians and neuroradiologists to diagnose the disease in the early stages and offer prompt treatment.