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Spinal Dural Arteriovenous Fistula : A Casereport, Hsiu-Fang Hsueh, Po-Hong Chen, Jo-Tong Chen, Ta-Shen Kuan

Rehabilitation Practice and Science

A case of delayed diagnosis of spinal dural arteriovenous fistula is presented. A 65-year-old male presented to our clinic for progressive stiffness and numbness over bilateral lower limbs for 6 months. Neurological examination was suggestive of thoracic spinal cord lesion with signs of both upper and lower motor neuron disorders. Electromyographic examination showed evidence of denervation and re-innervation in the bilateral paraspinal muscles of middle thoracic level. Magnetic resonance imaging (MRI) of the spine revealed trivial changes, but they were neglected initially. Because of clinical fluctuation and progressive deterioration, he was treated as early parkinsonism, stroke, amyotrophic lateral sclerosis, transverse …