Cervical Myelopathy Caused by Intracranial Dural Arteriovenous Fistula

Kim, Won Young; Kim, Jin Bum; Nam, Taek Kyun; Kim, Young Baeg; Park, Seung Won

doi:10.14245/kjs.2016.13.2.67

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…Enhancement of the tortuous veins after gadolinium may also be observed on T1-weighted MRI. 15 Nonetheless, as well as the case we present, these radiological clues can be missing. Additional evaluation with dynamic CT angiography (CTA), MRA, or digital subtraction angiography may also be performed.…”

Section: Lessonsmentioning

confidence: 57%

Tentorial dural arteriovenous fistula with perimedullary venous drainage–associated cervical myelopathy: illustrative case

Codina¹,

García²,

Sánchez³

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Tentorial dural arteriovenous fistulas (DAVFs) with perimedullary venous drainage causing cervical myelopathy are very uncommon conditions with an extremely aggressive behavior. When the characteristic radiological clues are missing, the unspecific clinical picture may cause delay and make the diagnosis challenging. OBSERVATIONS Here the authors report a case of a 58-year-old man who developed progressive spastic tetraparesis and dyspnea with an extensive mild enhancing cervical cord lesion initially oriented as a neurosyphilis-associated transverse myelitis. Acute worsening after steroid administration redirected the diagnosis, and a tentorial Cognard type V DAVF was elicited. The microsurgical disconnection process is described, and previously documented cases in the literature are reviewed. LESSONS If a DAVF is highly suspected, it is important to consider the possibility of its intracranial origin, and spinal as well as cerebral arteriography must be performed.

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Section: Lessonsmentioning

confidence: 57%

Tentorial dural arteriovenous fistula with perimedullary venous drainage–associated cervical myelopathy: illustrative case

Codina¹,

García²,

Sánchez³

et al. 2022

Journal of Neurosurgery: Case Lessons

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“…In addition, it is necessary to inform the patient to avoid intense and dangerous activities as much as possible to avoid injury or a sudden increase in blood pressure that may aggravate the condition. For patients with clinical symptoms, endovascular embolization or open surgery is recommended for active treatment to avoid subsequent bleeding or infarction in the future 33,34 . In this case, endovascular embolization was performed, and the postoperative recovery effect was significant.…”

Section: Discussionmentioning

confidence: 95%

Dural Arteriovenous Fistulas Presenting as Symmetric Lesions in the Internal Capsule on Imaging Studies

et al. 2023

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Background: Dural arteriovenous fistulas (DAVFs) leading to oedema, primarily in the internal capsule, are extremely rare and, to our knowledge, have never been reported. We reported a case of DAVFs with oedema in bilateral internal capsule oedema and reviewed the literature. Methods: The report describes a unique imaging presentation of cases of DAVFs as symmetric lesions, mainly in the bilateral internal capsule. It also reviews the literature for symmetric lesions in the internal capsule and central grey matter caused by DAVFs to further characterize this rare entity and differential diagnosis through imaging features. Results: In cases of symmetric oedema caused by DAVFs, the most common artery involved in arterial supply was the middle meningeal artery (13/24; 54%). The main vein involved in the drainage was the Galen vein (18/29; 62%). Most cases were treated with transarterial embolization (23/29; 79%), and the probability of effective treatment or complete cure is 100%. On imaging, the vasogenic oedema signal caused by DAVFs is a symmetrical lesion of the bilateral internal capsule, that is, DWI MRI shows a high signal in the unrestricted diffusion area on the apparent diffusion coefficient map. Conclusions: MR has good diagnostic value in abnormal basal ganglia symmetric signals caused by DAVFs, and can quickly identify DAVFs early.

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“…Endovascular embolization using embolic agents is the preferred treatment ( 15 ). The goal of treatment is to occlude the fistula and proximal venous drainage, reduce venous congestion and prevent the recruitment of collateral vessels ( 16 ). Adjacent vessels can be recruited and CCFs may recur if residues remain in the fistula and drainage veins.…”

Section: Discussionmentioning

confidence: 99%

Traumatic carotid‑cavernous fistula with perimedullary venous drainage and delayed myelopathy: A case report

Ding

Zhang

Feng

et al. 2021

Med Int

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Traumatic carotid-cavernous fistula (TCCF) with perimedullary venous drainage and delayed myelopathy is a relatively rare clinical lesion. Endovascular embolization using embolic agents is the preferred treatment for patients with a poor collateral circulation. The present study describes the case of a 45-year-old male with TCCF, who presented with progressive cervical myelopathy for 1 month. A previous history of the patient included an anterior skull base fracture induced by a traffic accident 2 years prior. Cervical spinal magnetic resonance imaging (MRI) revealed dilated perimedullary veins and cervical spinal cord edema. Cerebral digital subtraction angiography revealed a direct CCF with perimedullary venous drainage. The patient received endovascular treatment with coils and an Onyx liquid embolic system to occlude the fistula, and his symptoms were relieved when he was discharged 3 weeks later. The patient then felt normal and a cervical spinal MRI revealed the disappearance of the perimedullary veins dilation and spinal cord edema at the 6-month follow-up. To the best of our knowledge, only three cases of CCFs with perimedullary venous drainage presenting with myelopathy have been previously reported. The present study also discussed the possible pathological mechanisms for this rare presentation. Moreover, it is suggested that the possibility of CCFs as a cause of cervical myelopathy needs to be taken into consideration.

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Cervical Myelopathy Caused by Intracranial Dural Arteriovenous Fistula

Cited by 12 publications

References 11 publications

Tentorial dural arteriovenous fistula with perimedullary venous drainage–associated cervical myelopathy: illustrative case

Tentorial dural arteriovenous fistula with perimedullary venous drainage–associated cervical myelopathy: illustrative case

Dural Arteriovenous Fistulas Presenting as Symmetric Lesions in the Internal Capsule on Imaging Studies

Traumatic carotid‑cavernous fistula with perimedullary venous drainage and delayed myelopathy: A case report

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