Recovery after surgery of the spinal N24 SEP in dural arteriovenous malformation of the dorsal cord

We studied somatosensory evoked potentials (SEPs) to tibial nerve stimulation in two patients suffering from dorsal dural arteriovenous malformation (AVM). We found in both patients abnormalities in the lumbar N24 potential and in the cortical P40 response. After surgical removal of the AVM, the N24 recovered in both patients. Cord lesions probably occur in patients with dural AVM because of a theft of blood through the fistula; N24 recovery may therefore be associated with a restoration of blood supply after surgery. The N24 recovery in our patients with dural AVM suggests that the abnormality of this potential does not necessarily reflect irreversible damage to the lumbo-sacral cord and that the N24 recording can be useful in post-surgical monitoring.