Case Report

Foix-Alajouanine Syndrome: An Uncommon Cause of Myelopathy From an Anatomic Variant Circulation

Authors: Rajnish Mishra, MD, Roop Kaw, MD

Abstract

Foix-Alajouanine syndrome is a rare cause of myelopathy caused by dural arteriovenous malformation of the spinal cord, mostly lower thoracic and lumbar. Patients are usually over 50 years of age and can present with acute lower extremity dysesthesias or intermittent sciatica. Progression to paraplegia may be slow. Spinal angiography is needed for definitive diagnosis, based on the clues provided by the symptoms. If diagnosed early, vascular embolization or neurosurgical excision may be curative.


Key Points


* Foix-Alajouanine syndrome is a rare cause of myelopathy caused by dural arteriovenous malformation of the spinal cord, mostly lower and lumbar.


* Progression to full-blown myelopathy or paraplegia is slow, and patients may first present with acute lower extremity dysesthesias and intermittent sciatica.


* Repetitive subarachnoid hemorrhages typically produce severe local arachnoid fibrosis, associated thrombosis of local blood vessels, and progressive destruction of the spinal cord.


* Routine imaging and nonenhanced magnetic resonance imaging/computed tomography scans may yield nonspecific findings.


* Angiography is required to define the type of the lesion, and vascular embolization in the early stages of the disease may be curative.

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