LAUSR

A 56-year-old man complained of hypesthesia in the right lower extremity for 2 months. The same symptoms gradually involved the left lower extremity. Recent onset of dysuria was reported. Physical examination revealed diminished tendon reflexes in both lower extremities and diminished superficial and position sensation in the groin. MRI revealed a vascular malformation, ranging from T9 to L1 (figure). Spinal vessel digital subtraction angiography indicated a spinal dural arteriovenous fistula in the arteria radicularis magna arising from the right L1 intercostal artery and an intradural perimedullary arteriovenous fistula arising from the vertebral artery at C2 (video 1).