Rapid surgical intervention for acute spinal subdural hematoma triggered by ruptured spinal dural arteriovenous fistula: illustrative case

This is the fourth documented instance of a spinal dAVF presenting as a spinal SDH. Clinicians should consider this diagnosis in patients with acute paraplegia, back pain, and sphincter dysfunction, especially without trauma or coagulopathy. Diagnosis may be complicated by angiographically occult lesions due to a hematoma mass effect, making intraoperative imaging essential. Prompt surgical decompression and fistula disconnection can yield significant neurological recovery, as demonstrated in this case and limited literature. https://thejns.org/doi/10.3171/CASE25510.