Dural arteriovenous fistula of the lateral foramen magnum region: A review

Abstract

<jats:p> The lateral foramen magnum region is defined as the bilateral occipital area that runs laterally up to the jugular foramen. The critical vasculatures of this region are not completely understood. Dural arteriovenous fistulas that occur in this region are rare and difficult to treat. Therefore, we searched PubMed to identify all relevant previously published English language articles about lateral foramen magnum dural arteriovenous fistulas, and we performed a review of this literature to increase understanding about these fistulas. Four types of dural arteriovenous fistulas occur in the lateral foramen magnum region. These include anterior condylar confluence and anterior condylar vein dural arteriovenous fistulas, posterior condylar canal dural arteriovenous fistulas, marginal sinus dural arteriovenous fistulas, and jugular foramen dural arteriovenous fistulas. These dural arteriovenous fistulas share similar angioarchitectures and clinical characteristics. The clinical presentations of lateral foramen magnum dural arteriovenous fistulas include pulsatile tinnitus, intracranial hemorrhage, myelopathy, orbital symptoms, and cranial nerve palsy. Currently, head computed tomography, computed tomography angiography, magnetic resonance imaging, magnetic resonance angiography and digital subtraction angiography (DSA) are useful for diagnosing dural arteriovenous fistulas, and of these, DSA remains the “gold standard.” Most lateral foramen magnum dural arteriovenous fistulas need to be treated due to their aggressive symptoms, and transvenous embolization presents the best options. During treatment, it is critical to accurately place the microcatheter into the fistula point, and intraoperative integrated computed tomography and DSA data are very helpful. Other treatments, such as transarterial embolization, microsurgery or conservative treatment, can also be chosen. After appropriate treatment, most patients with lateral foramen magnum dural arteriovenous fistulas achieve satisfactory outcomes. </jats:p>

Dural arteriovenous fistulae at the lateral foramen magnum: A series of two microsurgical cases

“…Other important feeding arteries are the anterior and posterior meningeal arteries, and branches of the occipital artery. 3 DAVFs in our patients were coincidently supplied by hypoglossal and jugular branches of the neuromeningeal trunk arising from the ascending pharyngeal artery, in keeping with past studies. Surgery is widely accepted as a safe and effective approach to DAVFs at the foramen magnum.…”

“…The main feeding arteries of DAVFs at the foramen magnum frequently involve branches of the external carotid and vertebral arteries, of which the ascending pharyngeal artery is the most commonly involved. Other important feeding arteries are the anterior and posterior meningeal arteries, and branches of the occipital artery 3 . DAVFs in our patients were coincidently supplied by hypoglossal and jugular branches of the neuromeningeal trunk arising from the ascending pharyngeal artery, in keeping with past studies.…”

Microsurgical Obliteration of Craniocervical Junction Dural Arteriovenous Fistulas: Multicenter Experience

“…Microwire perforation, redistribution of venous drainage, and overdense coil packing leading to postoperative cranial nerve palsy remain complications associated with transvenous approaches, however. 14,15…”

Vaskuläre Malformationen im Hals-Nasen-Ohren-Bereich

“…5). Mittels einer digitalen Subtraktionsangiografie können die an der Fistel beteiligten Gefäße und der Blutfluss in der Fistel beurteilt werden [19].…”