Positional vomiting due to a thoracic spinal dural arteriovenous fistula

Abstract

<jats:p content-type="fine-print">✓ The authors report the unique case of a patient with a thoracic spinal dural arteriovenous fistula (DAVF) causing remote brainstem symptoms of positional vomiting and minimal vertigo. Magnetic resonance (MR) imaging of the brain demonstrated high signal abnormality in the medulla, presumably related to venous hypertension, and spinal MR imaging revealed markedly dilated veins along the dorsal aspect of the cord. Spinal angiography confirmed the presence of a thoracic spinal DAVF. Disconnection of the DAVF from the spine resulted in a marked improvement in symptoms and resolution of the preoperative MR imaging—documented abnormalities. The authors highlight the rare syndrome of positional vomiting as a brainstem symptom and conclude that spinal DAVFs should be considered in the differential diagnosis of high signal MR imaging abnormalities localized to the brainstem.</jats:p>

Intramedullary hemorrhage from a thoracolumbar dural arteriovenous fistula

“…These findings have been corroborated in a series of intracranial dural AVFs [109]. In our patient, the rate of arteriovenous transit was faster than that of other patients presenting without hemorrhage (1 vs. 2-3 [29] 20 0 0 Blackburn et al [30] 17 0 0 Bl ehaut et al [31] 10 0 0 Bowen et al [32] 8 0 0 Bradac et al [33] 13 0 0 Burrows et al [34] 1 0 0 Cabrera et al [35] 1 0 0 Cenzato et al [36] 37 0 0 Cenzato et al [37] 1 0 0 Cordato et al [38] 1 0 0 Criscuolo et al [39] 1 0 0 Deen et al [40] 1 0 0 Eskandar et al [41] 18 0 0 Finsterer et al [42] 1 0 0 Foote et al [43] 1 0 0 Gilbertson et al [44] 55 0 0 Hage et al [45] 5 0 0 Hall et al [46] 3 0 0 Hanakita et al [47] 2 0 0 Hassler et al [48] 18 0 0 Hasuo et al [49] 2 0 0 Houdart et al [50] 1 0 0 Huffmann et al [51] 18 0 0 Hurst et al [ seconds), and the draining vein was associated with a venous varix (Figs. 2 and 3).…”

Lumbar spinal dural arteriovenous fistula presenting with brainstem symptomatology: a case report

“…The first one presented with subarachnoid hemorrhage and intracranial venous drainage from a conus perimedullary arteriovenous fistula (8). The second one was a thoracic spinal DAVF presenting with symptoms of increased intracranial pressure (4). We report on the third case of spinal DAVF that caused brainstem dysfunction.…”

Inner Ear Conductive Hearing Loss and Unilateral Pulsatile Tinnitus Associated with a Dural Arteriovenous Fistula: Case Based Review and Analysis of Relationship between Intracranial Vascular Abnormalities and Inner Ear Fluids

“…DAVFs comprise 10% to 15% of all intracranial AVMs and, most often, involve the dura surrounding the sigmoid and transverse sinuses [ 6 ]. The mechanism of development of an acquired DAVF involves three steps: (1) thrombosis of a dural sinus, which leads to impaired venous drainage and increased dural sinus pressure; (2) subsequent dilation of physiologic shunts between the thrombosed sinus and extracranial arteries; and (3) recanalization of the dural sinus, which allows direct arterial shunting into the sinus from the external carotid system [ 7 ]. The Cognard classification ( Table 1 ) is one of several methods put forth to correlate the venous drainage pattern with the risk of neurologic complications, if the DAVF is untreated [ 8 , 9 ].…”