Spinal Dural Arteriovenous Fistulas with Segmental Arterial Supply Also Giving Rise to a Radiculomedullary Artery: A Case Report and Review of the Literature

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. Case Description 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.