Concerns About Dural AV Fistula: Should I Seek Emergency Care?
On January 24, I was admitted to the hospital under the suspicion of having a stroke due to experiencing weakness on my right side, numbness in my right face, and loss of vision in my right eye. Subsequent tests ruled out both stroke and transient ischemic attack (TIA). Following a series of MRIs, doctors suspect I might have a dural arteriovenous fistula affecting my thoracic spine. My symptoms are escalating, with occurrences shifting from monthly episodes to about every ten days, and more recently, twice just this week, including today. Today's troubling symptoms were related to both bowel and bladder control, numbness in my right cheek, and blurred vision in my right eye. My next neurologist appointment is on July 2, and I have a follow-up with a seizure specialist scheduled for August 27. Current medication includes 1500 mg of Keppra, taken twice daily, owing to focal slowing observed in my temporal lobe during sleep and awake EEG tests. Given my growing concerns, my healthcare manager recommended that I visit the emergency room today to document the escalating nature of my symptoms. Recent MRI findings indicate: 1. There is a stable appearance of unusually prominent veins along the surface of the distal thoracic spinal cord, the significance of which remains uncertain. While this could be indicative of a dural AV fistula, no associated abnormalities in spinal cord signals were noted. 2. No new intrinsic signal abnormalities or significant findings were detected, aside from some minimal degenerative changes noted previously. What do you think? I am a 48-year-old female, standing 63 inches tall and weighing 135 pounds. I have never smoked and do not have any other diagnoses. Multiple sclerosis has been ruled out by my neurologist.
Answers (1)
6/25/2025, 6:01:29 PM
OpenHealth AI
Your situation involves concerning neurological symptoms and potential complications related to a suspected dural arteriovenous fistula (AV fistula). Given the escalation of your symptoms, particularly those affecting bowel and bladder control, it's important to take proactive steps.
Main Points:
- Escalating Symptoms: Your recent symptoms, including bowel and bladder control issues, numbness, and blurred vision, are significant and warrant immediate attention.
- Emergency Care: Visiting the emergency room, as suggested by your healthcare manager, is a reasonable course of action to ensure that any serious complications are addressed and documented.
Explanation:
Dural AV fistulas can lead to various issues, including increased pressure in the vascular system and potential spinal cord compression, which aligns with your symptoms. The fact that your symptoms are becoming more frequent and severe—especially those impacting your daily functions—indicates a need for further evaluation.
Next Steps:
- Emergency Room Visit: Proceed to the emergency room to have your symptoms evaluated. Explain the escalation and provide them with your medical history, including your recent MRI results and medications.
- Monitor Your Symptoms: While you are en route to the ER, keep a record of your current symptoms, noting any changes or new developments (e.g., severity, duration).
- Stay Hydrated and Rest: Ensure you're well-hydrated and rest as much as possible while waiting for evaluation.
- Communicate Clearly: Make sure to communicate your concerns about the increase in symptoms and the potential implications of a dural AV fistula to the medical staff.
This approach is aimed at ensuring your safety and helping to clarify your diagnosis so appropriate management can be initiated. Your health and peace of mind are the top priorities, and seeking immediate care is essential given the current circumstances.
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