Rapidly Progressed Spinal Dural Arteriovenous Fistula Mimics Transverse Myelitis

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A 67 yearoldman came to our ER complaining of paraparesis and urinary incontinence. Two weeks prior to the admission, he recognized slowly progressing weakness in both lower legs along with urinary incontinence. On his first spinal magnetic resonance imaging (MRI) examination at an outside institution, there was a high signal lesion from the T5 level to the conus on T2weighted images and contrast enhancement around the cord. Longitudinally extensive transverse myelitis was their initial diagnosis. The patient was transferred to our hospital for further evaluation. Initial neurological examination revealed alert mental status. Muscles of lower extremities showed symmetrically increased tone with exaggerated ankle and knee jerk reflexes. The Barbinski sign was positive on both feet. Muscle