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February 12, 20260 citations

Spinal dural arteriovenous fistula masquerading as infiltrative intramedullary spinal cord tumor: illustrative case.

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AMAarathi ManchikalapudNINatasha IronsideCFCamilo E. Fadul

Key Points

  • The aim is to highlight how SDAVF can be mistaken for IMSCT and stress the importance of thorough investigation.
  • Evaluation of clinical symptoms and imaging studies
  • Use of digital subtraction angiography (DSA) for vascular assessment
  • Intraoperative ICG (indocyanine green) angiography during surgical intervention
  • SDAVF was successfully identified, which was initially misdiagnosed as IMSCT.
  • Emphasized the need for repeated imaging if initial tests do not show definitive findings.
  • Demonstrated that intraoperative angiography aids in accurately identifying vascular lesions.

Abstract

This case illustrates how SDAVF can masquerade as infiltrative IMSCT, emphasizing the importance of maintaining a high index of clinical suspicion for arteriovenous shunting during the workup of suspected IMSCT. A repeat DSA study should be considered when the initial DSA is negative, and in the setting of surgical exploration, the early use of intraoperative ICG angiography can be valuable for identifying pathology successfully. https://thejns.org/doi/10.3171/CASE25787.

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Cite This Study

Manchikalapud et al. (2026) studied this question.

synapsesocial.com/papers/698d6df45be6419ac0d53439https://doi.org/10.3171/case25787
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1AB137. SOH24AB_114. A rare presentation of a sacral dural arteriovenous fistula: a case report2024
  2. 2Precision Mapping: Intraoperative Indocyanine-Green Video Angiography in Thoracic Spinal Dural Arteriovenous Fistula, The Surgical Management: A Case Report2025
  3. 3Spinal Intradural Arteriovenous Shunt: Angiographic Characteristics and Treatment Outcomes2026
  4. 4The role of Surgery in the treatment of spinal Dural Arteriovenous fistula2025
  5. 5ABSTRACT NUMBER: ESOC2026A1639 SPINAL DURAL ARTERIOVENOUS FISTULA AS A DIAGNOSTIC PITFALL IN PROGRESSIVE MYELOPATHY: A CASE REPORT AND LITERATURE REVIEW2026