Highlights Spinal dural arteriovenous fistula is an uncommon cause of longitudinal transverse myelitis. Spinal dural arteriovenous fistula can be easily misdiagnosed. It usually presents with venous congestive myelopathy symptoms and misdiagnosis is common. Prescence of flow voids on MRI should raise the suspicion of underlying fistula. Intravenous steroid and lumbar puncture may be associated with acute neurological deterioration.

Highlights Early post-operative trans-anal shunt protrusion is a rare presentation. Patients may be asymptomatic. With concomitant bowel surgery, it may indicate intraoperative occult bowel injury. Early post-operative follow up shunt imaging is recommended in this group.

Highlights Direct fat grafting on sizable non-suturable dural tear should be avoided. Cranial fat dissemination can follow fat grafting for large non-suturable dural tear. Aseptic meningitis and hydrocephalus may result from cranial fat dissemination.