{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:18:32Z","timestamp":1769728712205,"version":"3.49.0"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"26","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,12,29]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Spinal dural arteriovenous fistulas (dAVFs) are rare vascular malformations that typically cause progressive congestive myelopathy. Hemorrhagic presentations of dAVFs, such as subdural hematomas (SDHs), are exceedingly rare and can lead to acute neurological deterioration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors present a case of spinal SDH secondary to a ruptured spinal dAVF. A 46-year-old woman presented with rapidly progressing paraparesis to complete paralysis within hours, without a history of trauma, anticoagulation, or infection. Thoracic spine MRI revealed an intradural, ventral extramedullary lesion from T4 to T7, consistent with a compressive hematoma. The patient underwent a thoracic laminectomy for evacuation. Intraoperative indocyanine green angiography identified a spinal dAVF near the left T7 nerve root sleeve, which was successfully clipped. At the 9-month follow-up, the patient had significantly recovered with 4\/5 strength in her lower extremities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This is the fourth documented instance of a spinal dAVF presenting as a spinal SDH. Clinicians should consider this diagnosis in patients with acute paraplegia, back pain, and sphincter dysfunction, especially without trauma or coagulopathy. Diagnosis may be complicated by angiographically occult lesions due to a hematoma mass effect, making intraoperative imaging essential. Prompt surgical decompression and fistula disconnection can yield significant neurological recovery, as demonstrated in this case and limited literature.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25510\">https:\/\/thejns.org\/doi\/10.3171\/CASE25510<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25510","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T11:59:58Z","timestamp":1769083198000},"source":"Crossref","is-referenced-by-count":0,"title":["Rapid surgical intervention for acute spinal subdural hematoma triggered by ruptured spinal dural arteriovenous fistula: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Abdul","family":"Naeem","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Windsor Regional Hospital, Windsor, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8480-9584","authenticated-orcid":true,"given":"Frank","family":"Mazza","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdalla","family":"Shamisa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Windsor Regional Hospital, Windsor, Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Curr Opin Neurol","first-page":"69","article-title":"Spinal dural arteriovenous fistula","volume":"19","author":"Koch","year":"2006","unstructured":"Koch C.Spinal dural arteriovenous fistula. Curr Opin Neurol. 2006;19(1):69-75."},{"issue":"2","key":"bib2","series-title":"J Neurosurg","first-page":"255","article-title":"Subdural hematoma from a Type I spinal arteriovenous malformation. Case report","volume":"90","author":"Han","year":"1999","unstructured":"Han PPTheodore NPorter RWDetwiler PWLawton MTSpetzler RF.Subdural hematoma from a Type I spinal arteriovenous malformation. Case report. J Neurosurg. 1999;90(2)(suppl):255-257."},{"issue":"5","key":"bib3","series-title":"Spine J","first-page":"e13","article-title":"High cervical spinal subdural hemorrhage as a harbinger of craniocervical arteriovenous fistula: an unusual clinical presentation","volume":"15","author":"Kasliwal","year":"2015","unstructured":"Kasliwal MKMoftakhar RO\u2019Toole JELopes DK.High cervical spinal subdural hemorrhage as a harbinger of craniocervical arteriovenous fistula: an unusual clinical presentation. Spine J. 2015;15(5):e13-e17."},{"key":"bib4","series-title":"Surg Neurol Int","first-page":"142","article-title":"Spinal dural arteriovenous fistula masquerading as subdural hematoma","volume":"11","author":"Huntoon","year":"2020","unstructured":"Huntoon KKhandpur UDornbos DYoussef PP.Spinal dural arteriovenous fistula masquerading as subdural hematoma. Surg Neurol Int. 2020;11:142."},{"key":"bib5","series-title":"World Neurosurg","first-page":"e306","article-title":"Spinal dural arteriovenous fistula: diagnosis, outcomes, and prognostic factors","volume":"144","author":"Ronald","year":"2020","unstructured":"Ronald AAYao BWinkelman RDPiraino DMasaryk TJKrishnaney AA.Spinal dural arteriovenous fistula: diagnosis, outcomes, and prognostic factors. World Neurosurg. 2020;144:e306-e315."},{"issue":"3 suppl","key":"bib6","series-title":"Glob Spine J","first-page":"174S","article-title":"An update of a clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the role and timing of decompressive surgery","volume":"14","author":"Fehlings","year":"2024","unstructured":"Fehlings MGTetreault LAHachem LAn update of a clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the role and timing of decompressive surgery. Glob Spine J. 2024;14(3 suppl):174S-186S."},{"key":"bib7","series-title":"Front Surg","first-page":"34","article-title":"Application of indocyanine green videoangiography in aneurysm surgery: evidence, techniques, practical tips","volume":"6","author":"Norat","year":"2019","unstructured":"Norat PSoldozy SElsarrag MApplication of indocyanine green videoangiography in aneurysm surgery: evidence, techniques, practical tips. Front Surg. 2019;6:34."},{"issue":"1","key":"bib1","series-title":"Curr Opin Neurol","first-page":"69","article-title":"Spinal dural arteriovenous fistula","volume":"19","author":"Koch","year":"2006","unstructured":"Koch C.Spinal dural arteriovenous fistula. Curr Opin Neurol. 2006;19(1):69-75."},{"issue":"2","key":"bib2","series-title":"J Neurosurg","first-page":"255","article-title":"Subdural hematoma from a Type I spinal arteriovenous malformation. Case report","volume":"90","author":"Han","year":"1999","unstructured":"Han PPTheodore NPorter RWDetwiler PWLawton MTSpetzler RF.Subdural hematoma from a Type I spinal arteriovenous malformation. Case report. J Neurosurg. 1999;90(2)(suppl):255-257."},{"issue":"5","key":"bib3","series-title":"Spine J","first-page":"e13","article-title":"High cervical spinal subdural hemorrhage as a harbinger of craniocervical arteriovenous fistula: an unusual clinical presentation","volume":"15","author":"Kasliwal","year":"2015","unstructured":"Kasliwal MKMoftakhar RO\u2019Toole JELopes DK.High cervical spinal subdural hemorrhage as a harbinger of craniocervical arteriovenous fistula: an unusual clinical presentation. Spine J. 2015;15(5):e13-e17."},{"key":"bib4","series-title":"Surg Neurol Int","first-page":"142","article-title":"Spinal dural arteriovenous fistula masquerading as subdural hematoma","volume":"11","author":"Huntoon","year":"2020","unstructured":"Huntoon KKhandpur UDornbos DYoussef PP.Spinal dural arteriovenous fistula masquerading as subdural hematoma. Surg Neurol Int. 2020;11:142."},{"key":"bib5","series-title":"World Neurosurg","first-page":"e306","article-title":"Spinal dural arteriovenous fistula: diagnosis, outcomes, and prognostic factors","volume":"144","author":"Ronald","year":"2020","unstructured":"Ronald AAYao BWinkelman RDPiraino DMasaryk TJKrishnaney AA.Spinal dural arteriovenous fistula: diagnosis, outcomes, and prognostic factors. World Neurosurg. 2020;144:e306-e315."},{"issue":"3 suppl","key":"bib6","series-title":"Glob Spine J","first-page":"174S","article-title":"An update of a clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the role and timing of decompressive surgery","volume":"14","author":"Fehlings","year":"2024","unstructured":"Fehlings MGTetreault LAHachem LAn update of a clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the role and timing of decompressive surgery. Glob Spine J. 2024;14(3 suppl):174S-186S."},{"key":"bib7","series-title":"Front Surg","first-page":"34","article-title":"Application of indocyanine green videoangiography in aneurysm surgery: evidence, techniques, practical tips","volume":"6","author":"Norat","year":"2019","unstructured":"Norat PSoldozy SElsarrag MApplication of indocyanine green videoangiography in aneurysm surgery: evidence, techniques, practical tips. Front Surg. 2019;6:34."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/26\/article-CASE25510.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/26\/article-CASE25510.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/26\/article-CASE25510.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:14:16Z","timestamp":1769685256000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/26\/article-CASE25510.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,29]]},"references-count":14,"journal-issue":{"issue":"26"},"URL":"https:\/\/doi.org\/10.3171\/case25510","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,29]]}}}