Middle-aged male with progressive paraparesis with a diagnosis of LETM. . 

This middle-aged male with progressive paraparesis for many months was transferred to our centre with a diagnosis of LETM. His symptoms worsened post IV-MP. Unless thin cuts are taken a T2 sagittal spine MRI can miss flow voids.
Spinal angio showed dural AVF with supply from two feeders. The distal feeder origin was at an acute angle with narrowing at the origin. To arrest the competitive flow, coils were deployed distal to this feeder and glue was injected and this feeder was occluded. A shaped headway duo 1.3 F was used to catheterise the proximal feeder and then dilute for was injected. Glue entry into the proximal vein was noted with complete obliteration of the fistula.
#DuralAVF #Paraparesis #LETM #IVMP #CoilEmbolization #GlueInjection #InterventionalRadiology #MedicalCase