Successful Management of Angiographically Occult Spinal Dural Arteriovenous Fistula with Multiple Draining Veins

Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal arteriovenous malformation and frequently cause progressive myelopathy. Early detection and surgical or endovascular intervention are important to preventing permanent neurologic impairment. Selective spinal angiography is still the gold standard for the diagnosis and localization of the SDAVF. Occasionally, these lesions may be angiographically occult. Here we report a case of an angiographically occult SDAVF, which was localized using magnetic resonance angiography. The lesion was successfully treated by direct surgery.