Treatment of Dural Arteriovenous Fistula with Intradural Draining Vein at the Craniocervical Junction: Case Series with Special Reference to the Anatomical Considerations

Choi, Jae-Hyeog; Park, Jung Cheol; Ahn, Jae Sung; Park, Wonhyoung

doi:10.1016/j.wneu.2023.04.103

Cited by 5 publications

(3 citation statements)

References 39 publications

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“…High cervical CCJ AVFs can be located on the inner or outer surface of the dura mater, on the spinal nerves, or on the spinal cord surface and can be divided into the following four types: DAVFs, radicular AVFs (RAVFs), epidural AVFs (EAVFs), and perimedullary AVFs (PAVFs) ( Figures 4 , 5 ), in which DAVFs and RAVFs tend to occur at the C1 level and EAVFs and PAVFs tend to occur at the C2 level ( 10 , 33 , 53 , 54 ).…”

Section: Angioarchitecture Of High Cervical Ccj Avfsmentioning

confidence: 99%

“…ASA and PSA can be involved in CCJ DAVFs. According to the feeding arteries and their relationships with the ASA and PSA, Choi et al ( 54 ) classified CCJ DAVFs into three types: type 1 was fed by the radiculomeningeal artery from the VA and was not associated with the ASA or PSA; type 2 was fed by the radiculomeningeal artery, and the radicular artery also supplied the PSA near the fistula point; type 3 had the characteristics of type 1 or type 2 DAVFs, except the ASA also contributed to the fistula; and type 3 was uncommon.…”

Section: Angioarchitecture Of High Cervical Ccj Avfsmentioning

confidence: 99%

“…EVT is only considered in CCJ AVFs with simple angioarchitecture, such as those with a single feeding artery and no pial feeding artery ( Figure 12 ) ( 3 ). For type 1 CCJ DAVFs, EVT may be considered ( 54 ). For instance, in the report by Murase et al, a CCJ DAVF with a single feeding artery was successfully embolized by glue under the balloon-assisted technique ( 66 ).…”

Section: Treatment Options For High Cervical Ccj Avfsmentioning

confidence: 99%

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Treatment of high cervical arteriovenous fistulas in the craniocervical junction region

2023

Front. Neurol.

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The craniocervical junction (CCJ) is a complex region. Rarely, arteriovenous fistulas (AVFs) can occur in the CCJ region. Currently, it is accepted that CCJ AVFs should only refer to AVFs at the C1-C2 levels. It is reasonable to assume that high cervical CCJ AVFs are being referred to when discussing CCJ AVFs. High cervical CCJ AVFs can be divided into the following four types: dural AVF, radicular AVF, epidural AVF and perimedullary AVF. Until now, it was difficult to understand high cervical CCJ AVFs and provide a proper treatment for them. Therefore, an updated review of high cervical CCJ AVFs is necessary. In this review, the following issues are discussed: the definition of high cervical CCJ AVFs, vessel anatomy of the CCJ region, angioarchitecture of high cervical CCJ AVFs, treatment options, prognoses and complications. Based on the review and our experience, we found that the four types of high cervical CCJ AVFs share similar clinical and imaging characteristics. Patients may present with intracranial hemorrhage or congestive myelopathy. Treatment, including open surgery and endovascular treatment (EVT), can be used for symptomatic AVFs. Most high cervical CCJ AVFs can be effectively treated with open surgery. EVT remains challenging due to a high rate of incomplete obliteration and complications, and it can only be performed in superselective AVFs with simple angioarchitecture. Appropriate treatment can lead to a good prognosis.

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