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The presentation of these lesions is variable. It may present as a pulsatile subcutaneous mass in the paravertebral musculature; dysphagia, if in the cervical region or with venous congestion myelopathy characterized by dilated perimedullary veins with central cord edema or compressive myelopathy due to mass effect from dilated epidural veins or with bruit. A paraspinal AVF with a high flow may even present as congestive heart failure. A paraspinal AVF is unique in terms of its relentless progression and challenges in diagnosis and management.[41]
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Benign lesions: Arachnoid cyst: Sagittal T1-weighted (A) and T2-weighted (B) images in a 72-year-old female, with long standing back ache, show a well-defined cerebrospinal fluid signal intensity lesion (arrow) in the posterior epidural space extending from T10 to L1 levels. The lesion effaces posterior epidural fat and shows mass effect on the spinal cord, which is displaced anteriorly