Foix-Alajouanine Syndrome Mimicking Longitudinally Extensive Transverse Myelitis.

Foix-Alajouanine syndrome is an arteriovenous malformation causing subacute congestive myelopathy that can lead to progressive paraplegia. It typically affects the lower thoracic and lumbosacral levels. Arteriovenous fistula (AVF) leads to increased venous pressure, decreasing the arteriovenous pressure gradient and leading to a decrease in spinal cord perfusion, oedema and necrosis. Early recognition and surgical intervention can result in a good prognosis. LEARNING POINTS: Spinodural arteriovenous fistula (SDAF) can present with longitudinally extensive transverse myelitis (LETM), progressive gait instability, and lower extremity weakness.Failure to promptly recognize this condition and misdiagnosis can result in a poor outcome.Microsurgical obliteration of the SDAF provides better results than embolization. © EFIM 2020.