case_images: PMC11766481_01
case_images: Case illustration: Pre-operative sagittal T2-weighted (A) and FLAIR MR imaging (B) of the thoracic region shows diffuse central spinal cord edema (white arrows) and flow voids (yellow arrow).
case_images: medicina-61-00101-g001.jpg
case_images: PMC11766481_01_medicina-61-00101-g001.jpg
case_images: medicina-61-00101-f001
case_images: A repeated MRI of the spinal axis depicted a progressive myelopathy, dilated perimedullary vessels and venous stasis (Figure 1).
case_images: (A) View of super-selective digital subtraction angiography (DSA) with the spinal DAVF showing the feeders from the radicular meningeal artery. (B) After the shunt spot (black arrows), the AV-Fistula continues upwards intradurally, draining into the perimedulary veins.
case_images: medicina-61-00101-g002.jpg
case_images: PMC11766481_01_medicina-61-00101-g002.jpg
case_images: medicina-61-00101-f002
case_images: A subsequent spinal DSA proved the diagnosis of sDAVF at the spinal thoracic level, T9-10 (Figure 2).
case_images: Spinal thoracic (T9) DAVF seen in ICG video-angiography mode (A) using digital 3D exoscope. Intraoperative ORBEYE-exoscope view (B) of the arterialized intradural vein (yellow arrows).
case_images: medicina-61-00101-g003.jpg
case_images: PMC11766481_01_medicina-61-00101-g003.jpg
case_images: medicina-61-00101-f003
case_images: Pathological vessels were visualized using exoscope-integrated fluorescence angiography with indocyanine-green (ICG) (Figure 3).
case_images: High-definition intraoperative exoscope image of the intradural venous vessels (yellow arrow) after bipolar coagulation.
case_images: medicina-61-00101-g004.jpg
case_images: PMC11766481_01_medicina-61-00101-g004.jpg
case_images: medicina-61-00101-f004
case_images: The sDAVF was occluded by coagulation (Figure 4) and then resected.
case_images: Case results: Post-operative sagittal (A) and axial (B) T2-weighted MR images show decrease in spinal cord edema (white arrows) three months after the operation.
case_images: medicina-61-00101-g005.jpg
case_images: PMC11766481_01_medicina-61-00101-g005.jpg
case_images: medicina-61-00101-f005
case_images: A postoperative MRI at the 3 month follow-up showed regressive spinal cord edema with still-detectable thoracolumbar myelopathy (Figure 5).