Paraplegia following lumbar puncture: a rare complication in spinal dural arteriovenous fistula

Excerpt

Spinal dural arteriovenous fistula (SDAVF) is the most common vascular disorder in the spinal cord with an annual incidence of 5–10 per 1,000,000 [1]. The patients with SDAVF usually present with progressive paraparesis accompanied by urinary and bowel disturbance that can be misdiagnosed with a broad spectrum of relatively more common spinal disorders including autoimmune or infectious myelopathies and spinal tumors. Since cerebrospinal fluid analysis is essential in the differential diagnosis, most patients with SDAVF undergo lumbar puncture. However, this procedure may change the pressure of the cerebrospinal fluid (CSF) abruptly that may lower the perfusion pressure of the spinal cord causing further ischemia. Herein, we report a patient with SDAVF who developed paraplegia a few hours after lumbar puncture. …