Arteriovenous Fistula Involving the Inferior Petroclival Vein  -Case Report-

Sugiura, Yoshimi; Nishizawa, Shigeru

doi:10.2176/nmc.51.45

Cited by 9 publications

(9 citation statements)

References 5 publications

(9 reference statements)

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“…5) based on the intraoperative findings combined with the detailed findings of multi-planer reconstruction (MPR) prepared by rotational angiography presented in a book written by Kiyosue et al 10) Pulsatile tinnitus is observed in many cases of DAVF of the ACC and that located around the hypoglossal canal, and symptoms, such as hypoglossal nerve palsy, have been reported, 5,6,11) but obstruction of the proximal side of the IPS may cause reflux into the CS, SOV, and SMCV and mainly induce ocular symptoms similar to those of DAVF of the CS, to which attention should be paid. 4,5,9,[11][12][13][14][15] The present case was similar to a previous case report in which blood flow refluxed in the IPS into the CS due to obstruction of the main venous drainage route, the proximal side of the IPS, and further reflux into the SOV mainly induced ocular symptoms similar to those of DAVF of the CS.…”

Section: Disclosure Statementsupporting

confidence: 89%

“…To our knowledge, only one case of DAVF with a shunt in this region has previously been reported, indicating that this is a very rare shunting region. 9) On postoperative cone beam CT, the coil mass was demonstrated continuously from the extracranial IPCV to the intracranial IPS. The presence of a shunting region in the IPCV was confirmed (Fig.…”

Section: Disclosure Statementmentioning

confidence: 97%

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A Case of Dural Arteriovenous Fistula Involving the Inferior Petroclival Vein

Hayashi

Kawanishi

Okubo

et al. 2019

JNET

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We report a very rare case of dural arteriovenous fistula (DAVF) involving the inferior petroclival vein (IPCV). Case Presentation: The patient was a 77-year-old woman. She suffered from right ophthalmalgia, pulsatile tinnitus, blepharedema, and chemosis, as well as right ptosis and diplopia (right oculomotor nerve palsy). Our imaging examinations demonstrated DAVF involving the IPCV. Since the proximal side of the right inferior petrosal sinus (IPS) was obstructed, the main venous drainage flow refluxed retrogradely from the IPS to the cavernous sinus (CS). Therefore, her clinical symptoms were similar to those of CS-DAVF. We successfully performed transvenous coil embolization (TVE) in the IPCV and IPS. Conclusion: We experienced a very rare case of DAVF involving the IPCV. We believe that it is important in each case to understand the 3D vascular anatomy by making full use of 3D-DSA and other modalities to accurately identify the shunt point and venous drainage structure.

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Section: Disclosure Statementsupporting

confidence: 89%

Section: Disclosure Statementmentioning

confidence: 97%

A Case of Dural Arteriovenous Fistula Involving the Inferior Petroclival Vein

Hayashi

Kawanishi

Okubo

et al. 2019

JNET

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“…A variety of devices, including detachable balloons, and transarterial or transvenous coils are used to occlude the fistula while attempting to maintain the patency of the vertebral artery 6–9. Our case report involved venous drainage into the anterior condylar confluence, which is the pathway for causing ocular symptoms, due to involvement of the inferior petrosal sinus10 11 In an extensive review, Spittau et al elegantly depicted the pathophysiology and treatment of hypoglossal canal dural arteriovenous fistulas, which may present with ocular symptoms similar to our case. Due to the complexity of the arterial–venous connections, a transjugular approach was the most commonly used treatment method, reserving transarterial treatment for lesions without venous access 12.…”

Section: Discussionsupporting

confidence: 61%

Republished: Vertebral–venous fistula: an unusual cause for ocular symptoms mimicking a carotid cavernous fistula

Felbaum

Chidambaram

Mason

et al. 2015

J NeuroIntervent Surg

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Vertebral-venous fistulas (VVF), or vertebral-vertebral arteriovenous fistulas, are an uncommon clinical entity. Typically, they present as a result of a direct vascular connection between an extracranial branch of the vertebral artery or its radicular components and the epidural venous plexus. These may manifest with signs and symptoms referable to cervical myelopathy secondary to compression or steal phenomenon. To our knowledge, this is the first case to identify a patient who presented with classic ocular symptoms attributable to a carotid cavernous fistula but secondary to a VVF. We present its treatment and clinical outcome. In addition, we present a brief literature review surrounding this uncommon disease.

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“…Endovascular surgery involves a catheter-based technique for embolization of the lumen of arteries feeding the DAVF, or directly into the vein draining the DAVF. The goal of treatment for intercavernous and carotid-cavernous sinus fistulas is to block the fistulous communications and thus decrease the hemodynamic burden in the cavernous sinus [11]. This can be accomplished either by occlusion of arterial feeders and proximal venous drainage through a transarterial approach or by retrograde transvenous occlusion of the sinus harboring the fistula.…”

Section: Discussionmentioning

confidence: 99%

Dural arteriovenous fistula discovered in patient presenting with recent head trauma

et al. 2013

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PatientMale, 32Final Diagnosis: Dural arterio-venous fistulaSymptoms: Eye redness • post-trauma headache • tinnitusMedication: —Clinical Procedure: Fistula embolizationSpecialty: NeurologyObjective:Mistake in diagnosisBackground:A dural arteriovenous fistula (DAVF), is an abnormal direct connection (fistula) between a meningeal artery and a meningeal vein or dural venous sinus. The pathogenesis of DAVF still remains unclear. Sinus thrombosis, head trauma, chronic central nervous system, hypercoagulable state, surgery, and hormonal influence are the pre-disposing factors that initiate this disease. The symptoms experienced by the patient will depend on the location of the fistula.Case Report:Thirty-two year old Hispanic male who presented one day after a rear ended motor vehicle collision (MVC) with a severe throbbing headache in the left parietal region, left eye redness but no retro-orbital pain and tinnitus in the left ear. He was initially misdiagnosed to have a carotid-cavernous fistula but upon cerebral angiogram was actually diagnosed with a dural arterio-venous fistula in the posterior fossa venous system followed by successful embolization of the fistula.Conclusions:A cerebral angiography is the gold standard for detection and characterization of a DAVF and will distinguish it from a CCF. Endovascular surgery involves a catheter-based technique for embolization of the lumen of arteries feeding the DAVF, or directly into the vein draining the DAVF. It is very important to recognize the typical findings of patients presenting with a DAVF then quickly proceeding with a cerebral angiogram to determine the exact location of the fistula and the appropriate treatment plan. By diagnosing and treating a DAVF as early as possible, the associated fatal complications can be averted.

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Arteriovenous Fistula Involving the Inferior Petroclival Vein -Case Report-

Cited by 9 publications

References 5 publications

A Case of Dural Arteriovenous Fistula Involving the Inferior Petroclival Vein

A Case of Dural Arteriovenous Fistula Involving the Inferior Petroclival Vein

Republished: Vertebral–venous fistula: an unusual cause for ocular symptoms mimicking a carotid cavernous fistula

Dural arteriovenous fistula discovered in patient presenting with recent head trauma

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