Congenital vascular malformations are largely known as rare entities. The prevalence of vascular malformations of the spinal cord is around 16%. Spinal arteriovenous malformations (AVM) are a heterogeneous group of lesions that may impair spinal cord function, and can be considered as a treatable cause of myelopathy.

According to localization they are classified as: dural, intradural, extradural, and complex, each one with a different arterial nutrition. According to the pathological anatomy it classifies in: cavernous angiomas, capillary hemangiomas and AV lesions.

The clinical manifestations of the spinal AVM are acute neurological deficits caused mainly by bleeding, or a subacute myelopathy, presenting as an insidious onset paraparesis associated with sensorial, intestinal, sexual and urinary dysfunction, based on the level (cervical to lumbar) of the lesion. The most common spinal vascular lesion in adults and elderly are dural arteriovenous fistulas prevalent in men and representing 56% of spinal vascular malformations.

After clinical suspicion, diagnosis is made by magnetic resonance imaging (IRM) which leads to selective medullary angiographies in order to determine type and subtype of medullary vascular malformation and, therefore, establish the most appropriate treatment.

Early rehabilitation permits acceptable functional recovery.