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Reversible brainstem dysfunction from spinal arterio-venous fistula
  1. M D Willis1,
  2. T Amato-Watkins2,
  3. M Zaben2,
  4. A Baig2,
  5. R Corkill1,
  6. Y Joshi3
  1. 1Department of Neurology, University Hospital of Wales, Cardiff, UK
  2. 2Department of Neurosurgery, University Hospital of Wales, Cardiff, UK
  3. 3Department of Radiology, University Hospital of Wales, Cardiff, UK
  1. Correspondence to Dr Mark Willis, Department of Neurology, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK; willismd{at}


A 45-year-old man presented with subacute onset of ataxia, diplopia, urinary retention and paraparesis. MR scan of brain showed abnormal T2 hyperintense signal within the cervical cord, medulla and lower pons and vascular appearances suggesting an arterio-venous fistula. The fistula was surgically explored and successfully disconnected with good clinical outcome. Brainstem or cervical dural arterio-venous fistulae more typically present as a myelopathy; only a handful of cases have presented with brainstem dysfunction. This is a rare but reversible cause of subacute brainstem dysfunction.

  • Cerebrovascular Disease
  • Clinical Neurology

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