TRAUMATIC ARTERIOVENOUS COMMUNICATION PRESENTING 36 YEARS AFTER INITIAL INJURY.

A 59-year-old man who had sustained multiple pelvic fractures 36 years ago recently developed progressive neurological deficits. His symptoms suggested an arteriovenous (AV) malformation of the spinal cord. This report details the steps taken in locating the fistula angiographically and in performing a preliminary temporary obliteration using an intra-arterial catheter balloon. After appropriate studies were carried out, the fistula was successfully excised. Immediate improvement in the peripheral circulation resulted, along with progressive ablation of the neurological deficits. A review of the literature has not revealed a similar case.