Fig. 1 To review the basic physiopathology features of spinal dural arteriovenous fistula. To describe the most relevant imaging findings on MRI emphasizing the optimal diagnostic approach for determining the fistula location.

Spinal dural arteriovenous fisulas are the most common type of spinal vascular malformation, accounting for approximately 70% (Fig. 1). They constitute a rare and enigmatic entity. Clinical features and structural changes were firstly recognized in 1926, pathophysiology and basics of treatment were known since 1974, and yet it remains unknown why these fistulas develop. Epidemiology: Most patients are middle or elderly men, which suggests an acquired origin, being trauma postulated as a potential cause. Fig. 2 Clinical manifestations: Symptoms as well as radiologic features are...

Given the nonspecific clinical findings, radiologist are often the first physicians who can suggest the diagnosis, which relies on MRI. Imaging features: Findings on MRI are clearly explained by the physiopathology of venous hypertension, and are divided into direct visualization of tortuous intradural extramedullary vessels, and changes in the spinal cord ( Fig. 8). Enlarged intradural channels are the most sensitive finding, manifesting as tortuous flow voids that enhance after contrast administration, mostly located at the dorsal surface of the cord in the lower thoracic...

The diagnosis of SDAVF is often delayed due to nonspecific clinical manifestation, leading to permanent disability. The radiologist should be aware of suggesting this entity when cord swelling, T2 multilevel intramedullary hyperintensity and prominent perimedullary vascularity are found on spine MRI.

J. M. López Arcas Calleja; Madrid/ES - nothing to disclose G. Liaño Esteso; Madrid/ES - nothing to disclose N. A. Abbas Khoja; Madrid/ES - nothing to disclose J. A. Blanco; Parla(Madrid)/ES - nothing to disclose E. D. Salazar Chiriboga; Madrid/ES - nothing to disclose

Fig. 20