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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
14:58

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

Foramen magnum dural arteriovenous fistulae with repeated subarachnoid haemorrhage

Y Kai1, J Hamada, M Morioka

  • 1Department of Neurosurgery, Kumamoto University Medical School; Kumamoto, Japan - ykai@kaiju.medic.kumamoto-u.ac.jp.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
|August 3, 2010
PubMed
Abstract

Insights

Dural arteriovenous fistulae at the foramen magnum are rare but can cause serious bleeding. Successful transarterial embolisation using coils and liquid material led to a stable outcome in a patient with recurrent subarachnoid hemorrhage.

Area of Science:

  • Neurology
  • Neurosurgery
  • Vascular Imaging

Background:

  • Dural arteriovenous fistulae (dAVF) in the foramen magnum region are uncommon vascular malformations.
  • These lesions can lead to significant morbidity, particularly from recurrent subarachnoid hemorrhage.

Purpose of the Study:

  • To report a case of foramen magnum dAVF presenting with repeated subarachnoid hemorrhage.
  • To describe the diagnostic findings and successful endovascular treatment of this rare condition.

Main Methods:

  • Diagnosis was established using magnetic resonance imaging (MRI) and digital subtraction angiography (DSA).
  • Treatment involved transarterial embolisation using a micro coil and liquid embolic agent.

Main Results:

  • MRI revealed abnormal extra-axial vascular structures adjacent to the medulla oblongata.
  • Angiography confirmed a dAVF supplied by meningeal arteries and draining into a subarachnoid vein with venous dilatation.
  • The patient showed a good clinical outcome with stable treatment results confirmed by follow-up angiography three years post-embolisation.

Conclusions:

  • Foramen magnum dAVF, though rare, poses a high risk of hemorrhage and necessitates timely intervention.
  • Endovascular embolisation is an effective treatment modality for managing these complex vascular lesions.

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