Prominent Dorsal Perimedullary Veins in SIH Mimic Spinal Dural AVF

In a series of six patients, prominent dorsal perimedullary veins in spontaneous intracranial hypotension (SIH) mimicked spinal dural arteriovenous fistula (dAVF). Key distinguishing features of SIH included orthostatic headache, brain sagging, and absence of cord edema, avoidin…

• Prominent dorsal perimedullary veins in SIH can be mistaken for a spinal dAVF, leading to unnecessary spinal angiography.
• Clinical features favoring SIH over dAVF: orthostatic headache, brain sagging, and lack of spinal cord edema or lower extremity weakness/paresthesia.

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