[Spinal epidural arteriovenous malformation fed by bilateral internal iliac arteries]

A rare case of a spinal epidural AVM fed by bilateral internal iliac arteries is reported. The patient was a 50 years old female with symptoms of slowly progressive paraparesis and sensory disturbance below L-2 associated with sphincter disorders. Myelography disclosed a serpiginous filling defect at the lumbar region. Selective internal iliac arteriograms disclosed an AVM fed by bilateral lateral sacral arteries. The nidus was excised totally, then a gradual improvement of those symptoms followed. Reviewing the literature, only 9 cases of spinal AVM of this type have been reported. In the majority of these cases, symptoms progressed slowly from the lower sacral level up to a level close to the end of the drainer. These symptoms were considered to be caused by steal phenomenon as well as by venous congestion due to arterialized intradural draining veins.