Rare, Intradural, Double Draining Veins in a Spinal Dural Arteriovenous Fistula

A 59-year-old man presented with a 9-month history of progressive weakness and numbness in his lower extremities (grade 4/5). Spinal MRI demonstrated extensive edema in the spinal cord and prominent intramedullary enhancement. Selective angiography revealed a right L1 spinal dural arteriovenous fistula (SDAVF) with intradural double draining veins (figure 1). The fistula was treated with surgery successfully. The patient's symptoms gradually improved after surgery. Postoperative MRI showed significant resolution of the edema and enhancement (figure 2). SDAVF with intradural double draining veins is extremely rare.1,2 This case clearly showed a rare draining pattern of intradural double draining veins in SDAVF.