Double spinal dural arteriovenous fistula with multiple draining veins: A case report.

Spinal dural arteriovenous fistulas (SDAVFs) are acquired arteriovenous shunts that occurs in the layers of the dura. Double-level SDAVFs with multiple draining veins are extremely rare. We present a rare case of double-level SDAVFs with multiple draining veins which was successfully managed in our hybrid theater. A 54-year-old male presented with 6-week progressive bilateral lower extremity paresis accompanied by urinary incontinence. Selective spinal angiography revealed multiple DAVFs at T6 and T9. Surgery was performed in our hybrid operating room because of complexity of both fistulas. Intraoperatively, angiography was performed to identify the SDAVFs prior to electrocoagulation and removed. The patient recovered with no further neurological deficits and 2 years follow-up revealed the patent is well and go about his daily duties. Intraoperative angiography is very helpful in identify the SDAVFs prior to electrocoagulation and removed.