Myelopathy due to large veins draining recurrent spontaneous caroticocavernous fistula

Narita, Yoshiaki; Watanabe, Yumiko; Hoshino, T; Okada, Mitsugu; Yamamoto, Yoichiro; Kuzuhara, Shigeki

doi:10.1007/bf00596510

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…Venous hypertension is more widely accepted; the fistula causes increased pressure in the perimedullary venous system with stagnation of the blood flow in intramedullary veins, leading to reduction in perfusion in microcirculation, and vasogenic oedema 11. However, there has been the occasional case of high-flow caroticocavernous fistula presenting with cervical myelopathy due to compression of the cervical spinal cord by dilated perimedullary veins 12. We wonder if there are altered patterns of venous drainage that can predispose to developing myelopathy in these patients.…”

Section: Discussionmentioning

confidence: 99%

Unusual case of intracranial dural AV fistula presenting with acute myelopathy

Abdelsadg

Kanodia²,

Keston

et al. 2016

BMJ Case Reports

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We present a case of intracranial arteriovenous fistula with perimedullary venous drainage presenting with acute myelopathy, which is an unusual presentation of this uncommon condition. Subsequent catheter angiogram defined the arterial feeders from the meningohypophyseal trunk and petrosal branch of the middle meningeal artery. The patient was successfully embolised, resulting in complete obliteration of the fistula, and significant resolution of brainstem and cervical cord changes along with clinical improvement.

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Section: Discussionmentioning

confidence: 99%

Unusual case of intracranial dural AV fistula presenting with acute myelopathy

Abdelsadg

Kanodia²,

Keston

et al. 2016

BMJ Case Reports

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“…The patient in the present study had the rare clinical presentation of myelopathy, and his cerebral DSA revealed a TCCF with posterior drainage into the perimedullary veins. To the best of our knowledge, only three cases of CCFs with progressive myelopathy have been reported to date, among which, two were spontaneous CCFs ( 3 , 4 ) and one was a TCCF ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

“…Typical TCCFs drain into the ophthalmic veins, which causes the progressive congestion of venous sinuses and subsequent pathognomonic ocular symptoms. However, the perimedullary venous drainage pathway and the presentation of delayed myelopathy in TCCF are rare, and only three cases to date have been reported (3)(4)(5), at least to the best of our knowledge. In addition, low-flow direct CCFs are also rarely reported.…”

Section: Introductionmentioning

confidence: 88%

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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Intracranial dural arteriovenous fistulae with perimedullary venous drainage. Anatomical, clinical and therapeutic considerations

et al. 1999

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We report five cases of intracranial dural arteriovenous fistula (DAVF) with perimedullary venous drainage. All the patients presented with rapidly progressive myelopathy and three had autonomic disorders. The DAVF were on the tentorium cerebelli (two cases), sigmoid (one), superior petrosal (one), and cavernous sinus (one). Slow venous drainage was directed through dilated perimedullary cervical veins. The transverse sinus was occluded in two cases. MRI, performed in four cases, demonstrated high signal on T2-weighted spin-echo sequences in the medulla oblongata and upper cervical spinal cord consistent with oedema, which signal resolved after complete cure of the DAVF in three cases. Embolisation was performed in all cases. It was followed by clinical deterioration in two cases and in the dramatic improvement in the other three, with complete clinical cure in two. Extensive venous thrombosis may explain the deterioration observed in one case.

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Myelopathy due to large veins draining recurrent spontaneous caroticocavernous fistula

Cited by 7 publications

References 14 publications

Unusual case of intracranial dural AV fistula presenting with acute myelopathy

Unusual case of intracranial dural AV fistula presenting with acute myelopathy

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

Intracranial dural arteriovenous fistulae with perimedullary venous drainage. Anatomical, clinical and therapeutic considerations

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