Spinal dural arteriovenous fistula (SDAVF) is the most common spinal vascular anomaly. It should always be considered in the differential diagnoses in a patient with progressive paraplegia or quadriplegia. We present a case of an elderly gentleman presenting with progressive paraplegia. The diagnosis was delayed as the previous physicians and radiologists missed the underlying key features of SDAVF on magnetic resonance imaging of the spine. Every neurologist and radiologist should be aware of these signs as SDAVF is mostly a treatable condition.
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