Related Experiment Video
Updated: Jul 13, 2026
14:58
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Dural arteriovenous fistula presenting as brainstem ischaemia
A Lagares1, A Perez-Nuñez, R Alday
1Department of Neurosurgery, Hospital 12 de Octubre, Madrid, Spain. algadoc@yahoo.com
Acta Neurochirurgica
|July 31, 2007
Summary
Cranial dural arteriovenous fistulas can cause brainstem issues due to venous hypertension. Surgical interruption of abnormal venous drainage led to full recovery in a presented case.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Dural arteriovenous fistulas (dAVFs) are abnormal connections between dura mater arteries and veins.
- Ascending myelopathy and brainstem dysfunction are rare presentations of dAVFs, often linked to venous hypertension.
Observation:
- A case of cranial dAVF presenting with brainstem dysfunction secondary to venous hypertension was observed.
- The fistula involved abnormal retrograde drainage through spinal veins, leading to increased venous pressure.
Findings:
- Surgical interruption of the pial venous drainage was performed.
- This intervention resulted in complete clinical and radiological resolution of the brainstem lesion.
Implications:
- This case highlights the importance of considering cranial dAVFs in patients with unexplained brainstem dysfunction.
- Surgical management targeting venous drainage can be effective in resolving these complex vascular lesions.
- Understanding venous hypertension mechanisms is crucial for treating dAVF-related neurological deficits.
Related Concept Videos
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:26Arteries of the Head and Neck
The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
01:10The Arch of Aorta
The coronary arteries, originating from the ascending aorta, bifurcate from two sinuses located within the ascending aorta. Positioned just above the aortic semilunar valve, these sinuses house essential aortic baroreceptors and chemoreceptors, crucial for maintaining cardiac function. The left coronary artery and the right coronary artery branch off from the left posterior and anterior aortic sinuses, respectively.
Encircling the heart, the coronary arteries form a ring-like structure before...
Encircling the heart, the coronary arteries form a ring-like structure before...
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:26Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...