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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Reversible brainstem dysfunction from spinal arterio-venous fistula.

M D Willis1, T Amato-Watkins2, M Zaben2

  • 1Department of Neurology, University Hospital of Wales, Cardiff, UK.

Practical Neurology
|June 28, 2014
PubMed
Summary
This summary is machine-generated.

A rare arteriovenous fistula caused subacute brainstem dysfunction in a patient, presenting with ataxia and diplopia. Surgical disconnection led to a good clinical outcome, highlighting a reversible cause of neurological symptoms.

Keywords:
Cerebrovascular DiseaseClinical Neurology

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Area of Science:

  • Neurology
  • Neurosurgery
  • Vascular Neurology

Background:

  • Cervical and brainstem dural arteriovenous fistulae are rare vascular malformations.
  • These fistulae typically manifest as myelopathy, affecting the spinal cord.

Observation:

  • A 45-year-old male presented with subacute onset of ataxia, diplopia, urinary retention, and paraparesis.
  • Cervical and brainstem MRI revealed T2 hyperintense signals and vascular abnormalities suggestive of an arteriovenous fistula.

Findings:

  • Surgical exploration and disconnection of the arteriovenous fistula were successfully performed.
  • The patient experienced a good clinical outcome following the surgical intervention.

Implications:

  • This case underscores that arteriovenous fistulae can present with brainstem dysfunction, not exclusively myelopathy.
  • It highlights a rare but treatable cause of subacute neurological deficits, emphasizing the importance of considering vascular causes.
  • Successful surgical management offers a reversible treatment option for this condition.