Spinal dural AV fistula: A nightmare for the anaesthesiologist

Spinal dural arteriovenous fistulas (SDAVFs) are abnormal connections between radicular arteries and venous plexus of the spinal cord.  SDAVFs most commonly present with pain and weakness in the lower limbs (which presents as difficulty in climbing stairs, gait disturbances)and sphincter dysfunction that is gradually progressive. We present a 31 year old woman who was diagnosed with stress urinary incontinence and was scheduled for tension free vaginal taping. Spinal anaesthesia was administered and post operatively the patient developed myoclonic jerks and weakness of the lower limbs. On evaluation she was found to have lumbar spinodural AV fistula.