Atypical Presentation of a High Grade dAVF Presenting with Severe Spasticity

This video presents a complex case of a high-grade dural arteriovenous fistula (dAVF) in a man in his 60s, who exhibited severe spasticity initially misdiagnosed as chronic seizures. Through detailed imaging studies including CT, CT perfusion, MRI, and cerebral angiography, the team identified aggressive venous congestion and a high-grade fistula with multiple feeding vessels.

The patient worsened rapidly with cerebral hemorrhage, prompting urgent endovascular treatment. Embolization using a Scepter Mini balloon catheter was performed via the external carotid arteries to effectively shut down the fistula. Post-intervention imaging showed normalization of cerebral perfusion and significant clinical improvement.