Intracranial dural arteriovenous fistula associated with progressive cervical myelopathy and normal venous drainage of the thoracolumbar cord: case report and review of the literature

Surgical Neurology
Christof RennerJürgen Meixensberger

Abstract

Intracranial dural arteriovenous malformations draining into the perimedullary venous system are rare lesions. In these cases, the selective spinal catheterization of all vessels with potential of causing that malformation was negative, and additional cerebral angiography usually reveals the fistula. Because of venous congestion of the cord caused by the DAVF, a delayed drainage or stagnation of contrast material in the artery of Adamkiewicz was considered as a compelling angiographic disorder so far. We report about a 58-year-old patient with a DAVF of the right posterior fossa draining into the cervical and upper thoracic plexus of medullary veins, followed by progressive cervical myelopathy and a normal venous drainage of the artery of Adamkiewicz. Because of the failing endovascular treatment option, the neurosurgical intervention was performed. The fistula was explored and clipped without any complications. Immediately after operation, the patient reported an improvement of his neurological deficits. About 38 cases of intracranial DAVFs draining into the perimedullary venous system are reported, but to our knowledge, this is the second one with a normal drainage of the artery of Adamkiewicz. The pathophysiological mechanis...Continue Reading

References

Apr 1, 1992·Journal of Neurosurgery·M D PartingtonD G Piepgras
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Citations

Nov 11, 2009·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Sara KhanRishi Gupta
Nov 28, 2012·Clinical Neurology and Neurosurgery·Umesh VivekanandaDavid H Miller
Jul 13, 2016·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Hengwei JinYouxiang Li
Oct 21, 2017·Chinese Medical Journal·Shan-Shan DuanChong-Bo Zhao
Apr 25, 2008·Neurologia Medico-chirurgica·Satoshi TsutsumiHajime Arai
May 23, 2019·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Yongjie MaFeng Ling
Dec 18, 2014·World Journal of Clinical Cases·Robert GrossMuhib Khan

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