{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:10:20Z","timestamp":1756375820519,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,1,9]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>Pediatric spinal vascular malformations are rare entities that typically present with symptoms from their effect on surrounding structures. Here we report a unique case of lumbar spinal dural\/perimedullary arteriovenous fistula (AVF) that presented with intraventricular hemorrhage and hydrocephalus. The previously healthy child presented with lethargy and headache, and initial imaging revealed only ventriculomegaly with trace intraventricular blood. His mental status improved with CSF diversion via an external ventricular drain. Further workup revealed a spinal AVF that was treated via endovascular embolization. His course was complicated by vasospasm requiring endovascular treatment and he eventually required ventriculoperitoneal shunt placement. He made a full recovery and has returned to his normal activities. This is a unique case of spinal AVF presentation and highlights the importance of considering imaging of the entire neuroaxis during workup for hydrocephalus.<\/jats:p>","DOI":"10.1136\/bcr-2019-015631","type":"journal-article","created":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T06:35:23Z","timestamp":1583303723000},"page":"e015631","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["A lumbar arteriovenous fistula presenting with intraventricular hemorrhage and hydrocephalus"],"prefix":"10.1136","volume":"13","author":[{"given":"Brandon A","family":"Miller","sequence":"first","affiliation":[{"name":"Neurosurgery, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0302-4588","authenticated-orcid":false,"given":"Robert Christopher","family":"Spears","sequence":"additional","affiliation":[{"name":"Neurosurgery, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas K","family":"Hines","sequence":"additional","affiliation":[{"name":"Neurosurgery, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulnasser","family":"Alhajeri","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5980-3989","authenticated-orcid":false,"given":"Justin F","family":"Fraser","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,3,3]]},"reference":[{"key":"2025082802462952000_13.3.e015631.1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.nec.2010.03.004","article-title":"Spinal cord vascular malformations in children","volume":"21","author":"Song","year":"2010","journal-title":"Neurosurg Clin N Am"},{"key":"2025082802462952000_13.3.e015631.2","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s00381-016-3035-0","article-title":"Pediatric spinal arteriovenous malformations and fistulas: a single institute's experience","volume":"32","author":"Cho","year":"2016","journal-title":"Childs Nerv Syst"},{"key":"2025082802462952000_13.3.e015631.3","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1159\/000490420","article-title":"Pediatric dilemma: endovascular versus surgical intervention for spinal vascular malformations","volume":"53","author":"Nikova","year":"2018","journal-title":"Pediatr Neurosurg"},{"key":"2025082802462952000_13.3.e015631.4","doi-asserted-by":"crossref","unstructured":"Yokosuka J , Fukaya S , Yamomoto S , et al . Intracranial subarachnoid hemorrhage caused by an aneurysm at the thoracic spinal region: case report and literature review. Br J Neurosurg 2019:1\u20135.doi:10.1080\/02688697.2019.1690130","DOI":"10.1080\/02688697.2019.1690130"},{"key":"2025082802462952000_13.3.e015631.5","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.wneu.2018.06.243","article-title":"Brainstem congestion due to dural arteriovenous fistula at the craniocervical junction: case report and review of the literature","volume":"118","author":"Wang","year":"2018","journal-title":"World Neurosurg"},{"key":"2025082802462952000_13.3.e015631.6","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.wneu.2018.04.211","article-title":"Reversible cerebral vasoconstriction syndrome as an unusual complication of a dural arteriovenous fistula treated with Onyx embolization","volume":"115","author":"Gonsales","year":"2018","journal-title":"World Neurosurg"},{"key":"2025082802462952000_13.3.e015631.7","first-page":"1","article-title":"Inflammation, vasospasm, and brain injury after subarachnoid hemorrhage","volume":"2014","author":"Miller","year":"2014","journal-title":"Biomed Res Int"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-015631","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:46:38Z","timestamp":1756374398000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-015631"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,3,3]]},"published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1136\/bcr-2019-015631"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-015631","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,3]]}}}