spinal pial fistula

Spinal pial arteriovenous fistulas (SPAVFs) are rare superficial intradural vascular malformations consisting of a direct shunt between spinal cord arteries and veins. More recently, the treatment choices for this pathology have gained alternative tools, and endovascular treatment in particular have consistently gained traction as one of the most efficient choices of treatment. Surgery has proven challenging, as the anterior localisation of the shunt predisposes spinal cord manipulation and, therefore, inherent oedema and in some cases ischaemic post-operative changes in the spinal cord tissue. Surgery has increasingly been reserved for cases in which the first option of endovascular treatment is not feasible. We report a case of a type IVc SPAVF that was treated with the association of coils and glue.