Case Report

CSF-venous fistulae—An underrecognized cause of superficial siderosis:

This case report presents a rare instance of superficial siderosis (SS) caused by a cerebrospinal fluid–venous fistula (CSF-VF) in the thoracic spine. A man in his 60s exhibited symptoms including chronic right-sided headache, anosmia, bilateral tinnitus, and gait instability. MRI showed extensive SS without evidence of intracranial hypotension. CT myelography revealed a thoracic CSF-VF associated with nerve root dural ectasia. The fistula was successfully treated via transvenous embolization, resulting in progressive clinical improvement. This case emphasizes the need to consider CSF-VF in patients with SS, particularly when conventional imaging lacks typical features like dural tears or epidural fluid collections.

From Division of Neurointerventional Radiology, Lahey Hospital & Medical Center – 41 Mall Rd, Burlington, MA 01805, USA.

View at: https://doi.org/10.1177/15910199251339542

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