Dural Arteriovenous Fistula at the Foramen Magnum with Holocord Myelopathy: Case Report

Lee, Jong‐Young; Cho, Young Dae; Kwon, Bum Sun; Han, Moon Hee

doi:10.5469/neuroint.2010.5.1.53

Cited by 4 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We reviewed the published case reports which have sufficient clinical description and clearly demonstrated figures of foramen magnum DAVFs. [39131620212223242526272829303132333435] The collected data in this review include demographic data (i.e., gender and age of patient), presenting symptoms, the findings of image studies, arterial feeders of the fistula, location of the draining veins, the presence of venous varix, treatment of the fistula, and neurological outcomes following treatment [Table 1]. From the literature review, there were 27 cases, including our case, with 27 foramen magnum DAVFs.…”

Section: Discussionmentioning

confidence: 99%

Medullary hemorrhage caused by foramen magnum dural arteriovenous fistula successfully obliterated using combination of endovascular and surgical treatments: A case report and literature review

et al. 2019

View full text Add to dashboard Cite

The authors describe an extremely rare case of foramen magnum dural arteriovenous fistula (DAVF), Cognard type V, presented with medullary hemorrhage caused by venous varix on the lateral medullary draining vein embedded into the medulla oblongata. Following mild myelopathy for 3 days, a 20-year-old male developed dyspnea, generalized seizures, loss of consciousness, and finally cardiac arrest. After successful resuscitation, computed tomography scan (CT) of the brain was obtained and showed acute medullary hemorrhage. Subsequent magnetic resonance imaging of the brain revealed diffuse venous congestion or edema of the medulla with multiple dilated flow voids surrounding the medulla, more prominent on the left side, with venous varix embedded into the left-sided of the lower medulla. He was sent to the emergency department of the local hospital and intubated promptly. A few minutes later, the patient had a cardiac arrest. Digital subtraction angiography (DSA) demonstrated DAVF of the foramen magnum supplied mainly by dural branches of bilateral hypertrophic posterior inferior cerebellar arteries (PICAs), slightly by the posterior meningeal branch of the left vertebral artery, and the jugular branch of the left ascending pharyngeal artery (APA) originating from the occipital artery. Transarterial embolization through the bilateral dural branches of the PICAs was successfully performed using N-butyl-2-cyanoacrylate (NBCA), resulting in complete obliteration. The patient had excellence recovery and lost to annual follow-up. Seven years later, he had a recurrent of the fistula presented with occipital headache. DSA with angiographic CT in three-dimensional reconstruction and maximum intensity projection reformatted images clearly demonstrated the exact location of the DAVFs at the posterior rim of the foramen magnum, mainly recruited by the hypertrophic jugular branch of the APA originating from the occipital artery. The fistula was successfully treated surgically following transarterial embolization through the jugular branch of the APA using NBCA. Follow-up DSA confirmed complete obliteration of the DAVF. The patient has remained clinically asymptomatic 2 years after the operation.

show abstract

Section: Discussionmentioning

confidence: 99%

Medullary hemorrhage caused by foramen magnum dural arteriovenous fistula successfully obliterated using combination of endovascular and surgical treatments: A case report and literature review

et al. 2019

View full text Add to dashboard Cite

show abstract

“…In order to analyze the clinical features of this specific D-AVF at the foramen magnum fed by the APA, we searched relevant published articles, and overall eleven corresponding cases were found in eight articles ( Table 1 ). 5) 7) 9) 11) 12) 13) 17) 22) Nine patients presented with myelopathy, only one with SAH, and remaining one with pulsatile tinnitus and abducent nerve palsy. Seven patients had only inferior directing drainage into the spinal venous systems and they all presented with myelopathic symptoms.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Subarachnoid Hemorrhage caused by Ruptured Venous Varix Due to Dural Arteriovenous Fistula at the Foramen Magnum Fed Solely by the Ascending Pharyngeal Artery

Kim

Lee

Kang

et al. 2018

J Cerebrovasc Endovasc Neurosurg

View full text Add to dashboard Cite

Dural arteriovenous fistula (D-AVF) at the foramen magnum is an extremely rare disease entity. It produces venous hypertension, and can lead to progressive cervical myelopathy thereafter. On the other hand, the venous hypertension may lead to formation of a venous varix, and it can rarely result in an abrupt onset of subarachnoid hemorrhage (SAH) when the venous varix is ruptured. The diagnosis of D-AVF at the foramen magnum as a cause of SAH may be difficult due to its low incidence. Furthermore, when the D-AVF is fed solely by the ascending pharyngeal artery (APA), it may be missed if the external carotid angiography is not performed. The outcome could be fatal if the fistula is unrecognized. Herein, we report on a rare case of SAH caused by ruptured venous varix due to D-AVF at the foramen magnum fed solely by the APA. A review of relevant literatures is provided, and the treatment modalities and outcomes are also discussed.

show abstract

“…Although rare, syrinx and holocord have more recently been associated with previously unsuspected conditions such as (1) a dural arteriovenous fistula at the level of the foramen magnum [ 252 ], (2) cervical spondylosis [ 253 ], (3) stenosis of the thoracic spine [ 254 ], (4) a sacral arachnoid cyst [ 255 ], and (5) a tethered cord [ 256 ]. All of these cases were likewise attributed to altered CSF flow and pressure gradients in the spinal canal and cord.…”

Section: Hydrocephalus Hydromyelia and Ccjmentioning

confidence: 99%

The Role of the Craniocervical Junction in Craniospinal Hydrodynamics and Neurodegenerative Conditions

Flanagan

2015

Neurology Research International

View full text Add to dashboard Cite

The craniocervical junction (CCJ) is a potential choke point for craniospinal hydrodynamics and may play a causative or contributory role in the pathogenesis and progression of neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, MS, and ALS, as well as many other neurological conditions including hydrocephalus, idiopathic intracranial hypertension, migraines, seizures, silent-strokes, affective disorders, schizophrenia, and psychosis. The purpose of this paper is to provide an overview of the critical role of the CCJ in craniospinal hydrodynamics and to stimulate further research that may lead to new approaches for the prevention and treatment of the above neurodegenerative and neurological conditions.

show abstract

Dural Arteriovenous Fistula at the Foramen Magnum with Holocord Myelopathy: Case Report

Cited by 4 publications

References 5 publications

Medullary hemorrhage caused by foramen magnum dural arteriovenous fistula successfully obliterated using combination of endovascular and surgical treatments: A case report and literature review

Medullary hemorrhage caused by foramen magnum dural arteriovenous fistula successfully obliterated using combination of endovascular and surgical treatments: A case report and literature review

A Rare Case of Subarachnoid Hemorrhage caused by Ruptured Venous Varix Due to Dural Arteriovenous Fistula at the Foramen Magnum Fed Solely by the Ascending Pharyngeal Artery

The Role of the Craniocervical Junction in Craniospinal Hydrodynamics and Neurodegenerative Conditions

Contact Info

Product

Resources

About