Unmasking of a spinal dural AV fistula on MRI following steroid administration

Abstract Background Spinal dural arteriovenous fistulas (dAVF) remain a rare, diagnostically challenging and possibly correctable condition with important prognostic outcomes dependent primarily on early detection treatment. Case presentation We present case of 73-year-old male progressively worsening neurological symptoms after steroid administration for presumed diagnosis transverse myelitis. This is extremely unique, as the steroids helped unmask an underlying spinal fistula by revealing characteristic imaging findings dAVF, not seen original MRI study. Conclusion In setting unclear cause myelitis following administration, possibility ‘masked’ AVF should be considered repeat performed, which might help in eventual definitive treatment this elusive entity.