Acute Paraparesis after Epidural Corticosteroid Injection Revealing Spinal Dural Arteriovenous Fistula in a HIV Patient

Authors

• Anouk Le Goueff Internal Medicine Department, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
• Nicolas Mavroudakis Centre de Référence Neuromusculaire, Service de Neurologie, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
• Benjamin Mine Interventional Neuroradiology Department, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
• Olivier De Witte Neurosurgery Department, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
• Gauthier Remiche Centre de Référence Neuromusculaire, Service de Neurologie, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium

Anouk.le.goueff@ulb.be

Keywords

Abstract

Spinal dural arteriovenous fistulas (SDAVFs) are often misdiagnosed as their symptoms are non-specific, leading to treatment delay and a poor outcome.
We describe the case of a 53-year-old man with a history of progressive paraparesis that worsened abruptly after an epidural corticosteroid injection. We highlight here the need for high diagnostic suspicion for an SDAVF in patients deteriorating after an epidural injection and an indication of repeated spine imaging in such cases.
Finally, this is the first reported case of an SDAVF in a HIV-positive patient and it emphasizes the need for a broad differential diagnosis.