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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Transverse-sigmoid sinus dural arteriovenous fistula presenting with parkinsonism
Tomoji Hattori1, Taku Takeuchi, Ryusuke Kabeya
1Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi 491-8558, Japan. hatket@nifty.com
Abstract:
Dural arteriovenous fistula (DAVF) is rarely associated with parkinsonism. A 52-year-old woman presented with a rare case of DAVF manifesting as parkinsonism and subsequently akinetic mutism. She showed dramatic recovery after endovascular treatment. We also review 10 published reports of DAVF presenting with parkinsonism. The clinical features of these cases at presentation was more closely compatible with lower body parkinsonism or vascular parkinsonism rather than Parkinson's disease. Most lesions are located at the transverse-sigmoid sinus (TSS) with venous reflux into the straight sinus with probable venous congestion of the basal ganglia. Most importantly, parkinsonism due to TSS DAVF is reversible if embolization is achieved successfully.
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