Cranial dural arteriovenous fistulas (DAVFs) may give rise to myelopathy due to spinal perimedullary venous drainage causing intramedullary venous hypertension. Such cases are uncommon but not rare, with several cases reported in the literature. We report a case of foramen magnum DAVF presenting with symptoms of tetraparesis. The unusual feature was that in this case it was due to compression of the cervicomedullary junction by a large venous pouch rather than the result of spinal perimedullary venous hypertension. Transarterial glue embolization achieved good reduction of flow in the fistula with shrinkage of the venous pouch and corresponding clinical improvement.
DaviesMASalehJterBruggeK: The natural history and management of intracranial dural arteriovenous fistulae. Part 1. Benign lesions. Interventional Neuroradiology3: 295–302, 1997.
4.
DaviesMAterBruggeKWillinskyRA: The natural history and management of intracranial dural arteriovenous fistulae. Part 2. Aggressive lesions. Interventional Neuroradiology3: 303–11, 1997.
YoshidaSOdaY: Progressive myelopathy caused by dural arteriovenous fistula at the craniocervical junction-case report. Neurologia Medico-Chirurgica39(5): 376–379, 1999.
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OishiHOkudaO: Successful surgical treatment of a dural arteriovenous fistula at the craniocervical junction with reference to pre- and postoperative MRI. Neuroradiology41(6): 463–467, 1999.
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HahnelSJansenOGeletnekyK: MR appearance of an intracranial dural arteriovenous fistula leading to cervical myelopathy. Neurology51(4): 1131–1135, 1998.
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ErnstRJGaskill-ShipleyM: Cervical myelopathy associated with intracranial dural arteriovenous fistula: MR findings before and after treatment. Am J Neuroradiol18(7): 1330–1334, 1997.
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MascalchiMScazzeriF: Dural arteriovenous fistula at the craniocervical junction with perimedullary venous drainage. Am J Neuroradiol17(6): 1137–1141, 1996.
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DeopujariCEDadachanjiMCSinghalBS: Cervical myelopathy caused by an intracranial dural arteriovenous fistula. British J Neurosurg9(5): 671–674, 1995.
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BretPSalzmannM: Dural arteriovenous fistula of the posterior fossa draining into the spinal medullary veins- an unusual cause of myelopathy: Case report. Neurosurgery35(5): 965–968, 1994.
14.
VersariPPD'AlibertiG: Progressive myelopathy caused by intracranial dural arteriovenous fistula: Report of two cases and review of the literature. Neurosurgery33(5): 914–918, 1993.
