Related Experiment Videos
[Cavernous arteriovenous fistula presenting myelopathy: a case report]
Hiroyuki Ohnishi1, Jun Deguchi, Makoto Yamada
1Department of Neurosurgery, Osaka Medical College, 2-7 Daigaku-cho, Takatuki-city, Osaka 569-8686, Japan. neu086@poh.osaka-med.ac.jp
No Shinkei Geka. Neurological Surgery
|November 6, 2003
Summary
Intracranial dural arteriovenous fistula (DAVF) can cause myelopathy, a rare spinal cord condition. Prompt diagnosis and embolization treatment led to significant patient recovery.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Intracranial dural arteriovenous fistulas (DAVFs) are abnormal connections between dura mater arteries and veins.
- Myelopathy, a dysfunction of the spinal cord, is an uncommon presentation of intracranial DAVFs.
Observation:
- A 76-year-old woman presented with tetraparesis and sphincter dysfunction.
- MRI revealed T2 high signal intensity in the medulla oblongata to upper cervical cord.
- Angiography identified a cavernous DAVF with venous drainage into perimedullary spinal veins.
Findings:
- The patient's myelopathy was attributed to spinal venous congestion secondary to the DAVF.
- Transarterial embolization of the cavernous sinus successfully treated the DAVF.
- Post-embolization, neurological deficits and spinal cord signal abnormalities resolved.
Implications:
- Intracranial DAVF should be considered in the differential diagnosis of myelopathy of unknown origin.
- Embolization is an effective treatment for DAVF-induced myelopathy.
- This case highlights the importance of advanced neuroimaging and endovascular techniques.