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A cervical dural arteriovenous fistula in a patient presenting with radiculopathy. Case report
1Department of Neurosurgery and Neurology, Tokyo Metropolitan Neurological Hospital, Japan.
Insights
A rare cervical dural arteriovenous fistula (AVF) caused radiculopathy. Surgical treatment after embolization effectively relieved nerve root compression and improved arm weakness.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Cervical dural arteriovenous fistulas (AVFs) are rare vascular malformations.
- Radiculopathy can be a presenting symptom of cervical AVFs.
- Accurate diagnosis and effective treatment are crucial for patient outcomes.
Abstract:
A 51-year-old man presenting with radiculopathy a rare cervical dural arteriovenous fistula (AVF) is reported. Angiography revealed that the cervical dural AVF was fed mainly by the left C-3 and C-4 radicular arteries and drained into the internal vertebral venous plexus with no communication with intradural structures. The dural AVF was treated surgically after embolization therapy. Although the AVF showed mass effect on computerized tomography (CT) scanning, abnormal vessels, which were suspected to drain the AVF, were observed intraoperatively to compress the left C-4 and C-5 nerve root sleeves. After resection of these abnormal epidural vessels, monoparesis of the left proximal upper extremity was markedly improved. In this patient, dynamic CT scanning was useful in the initial diagnosis, and the preoperative embolization therapy was very effective.
