Cervical spinal arteriovenous fistula with ventral perimedullary venous drainage

Background Spinal arteriovenous fistula (AVF) represents the most common type of spinal vascular lesions and is often associated with progressive neurological dysfunction. Method Here, we present a unique case of a spinal vascular malformation that does not fit the traditional classification schemes. The patient presented with progressive neurologic deficits resembling partial Brown-Sequard syndrome and was subsequently found to have a lesion resembling type I spinal AVF. However, this intradural fistula drained into the ventral venous plexus rather than dorsal. Conclusion Recognizing these rare anatomical variants is paramount in achieving successful obliteration and improved functional outcome for patients.