27 June 2024
: Case report 
Spinal Dural Arteriovenous Fistula with Low Back Pain as the Only Symptom at Onset: A Case Report
Unknown etiology, Mistake in diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Adverse events of drug therapy
Hui Ouyang1ABCDEF, Shuo Zhang1BDE, Fei Xu1BDF, Wenjing Lin2BC, Zunjing Liu3ADG*, Huailian Guo34ACEFDOI: 10.12659/AJCR.943947
Am J Case Rep 2024; 25:e943947
Table 1. Summary of the patient’s treatment process.
| 71/Male, Chinese (Han nationality) | ||||
| 1 year of lower back pain, 7 days of left lower-limb weakness | ||||
| 19-year history of atrial fibrillation and received radiofrequency ablation; over 10-years of coronary heart disease; intestinal cancer and received surgical resection. No abnormalities in family history | ||||
| Nothing special in family history | ||||
| First visit | Second visit | Third visit | Fourth visit | |
| May 28, 2023 | May 29, 2023 | June 6, 2023 | June 21, 2023 | |
| Hospital A in Hebei province | Hospital B in Hebei province | Neurology Department of Peking University People’s Hospital | Neurosurgery Department of Peking University People’s Hospital | |
| Myofasciitis | Spinal demyelinating disease | Spinal cord lesions: spinal vascular malformation? Spinal cord demyelinating disease? | Spinal dural arteriovenous fistula | |
| Local blocking with “betamethasone, lidocaine” once | Intravenous infusion of traditional Chinese medicine extract to improve circulation(specific details unknown) | Methylprednisolone 500 mg qd iv, 3 days;Pantoprazole 40 mg qd iv, 3 days;Glycerin fructose 250 ml qd iv, 3 days;Ginaton 80 mg tid po, 3 days;Potassium chloride 0.5 tid po, 3 days; Vitamin b1 10 mg tid po and mecobalamin 500 µg qd im for the whole hospital course | Enoxaparin 4000 IU qd, ih, 13 days;Hydroxyethyl starch 1000 ml qd iv, 13 days; Aescine 20 mg qd iv, 13 days;Cefuroxime 1.5 g q8h, 5 days;And then Sulperazone 3 g q12h iv, 11 days | |
| Spinal dural arteriovenous fistula excision | ||||
| Developed left lower-limb weakness, accompanied by numbness | No significant improvement was observed | Worsening left lower-limb weakness | Lower-limb muscle strength recovered, numbness disappeared | |