Spinal arteriovenous fistula leading to acute paraplegia after a lumbar nerve root block: Successful embolization with complete neurological recovery-a case report.
Diego Gonzalez-Morgado, Marta de Dios-Lascuevas, Ferran Blasco-Casado et al.
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Case in brief
A patient developed complete spinal cord injury with acute paraplegia after a lumbar nerve root block. Evaluation identified a spinal arteriovenous fistula that had likely been undiagnosed before the procedure. The fistula was treated with endovascular embolization, after which the patient made a complete neurological recovery. The report describes the fistula as the likely explanation for the abrupt deterioration, while noting that factors triggering sudden decline in spinal arteriovenous fistulas are not fully understood.
What made this case unusual
The acute, complete neurological deficit followed a lumbar nerve root block in a patient with a likely previously undiagnosed spinal arteriovenous fistula.
Diagnostic / clinical pearl
Consider an underlying spinal arteriovenous fistula when acute myelopathy occurs after a lumbar nerve root block; the report documents complete recovery following endovascular embolization.