No shinkei geka. Neurological surgery
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An 82-year-old man presented with lower extremity weakness, paresthesia, and gait disturbance. At the previous hospital, spinal MRI had demonstrated a high-intensity area confined to the thoracic spinal cord on T2-weighted images and prominent dorsal venous flow voids that were suggestive of a thoracolumbar dural arteriovenous fistula(dAVF). Spinal digital subtraction angiography(DSA)failed to detect the shunt point. ⋯ Surgery improved his symptoms, and the abnormal imaging findings were resolved. Observation of a dAVF at the CCJ with myelopathy is rare, and the diagnosis of this type of dAVF might be challenging. MRDSA might be a useful tool for detecting this uncommon dAVF.