Duplicated origin of a radiculomedullary artery supplying a perimedullary arteriovenous fistula: Angiographic observation and developmental considerations

The angiographic observation of a radiculomedullary artery variation found in a patient with a spinal cord vascular malformation is presented. A posterior radiculomedullary artery arising from the left L2 intersegmental artery had a duplicated origin. Two radicular trunks were seen aiming towards the neural foramen: a dominant anterior one providing a retrocorporeal artery and the anterior limb of the radicular artery, and a smaller posterior one branching off a prelaminar artery and the posterior limb of the radicular artery. The two limbs then joined to continue as a single posterior radiculomedullary artery, which participated in the vascularization of the vascular malformation. The clinical and developmental aspects of this exceptional variant are discussed.