Browse > Article
http://dx.doi.org/10.3340/jkns.2014.55.3.152

Brainstem Congestion due to Dural Ateriovenous Fistula at the Craniocervical Junction  

Wu, Qi (Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University)
Wang, Han-Dong (Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University)
Shin, Yong Sam (Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Zhang, Xin (Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University)
Publication Information
Journal of Korean Neurosurgical Society / v.55, no.3, 2014 , pp. 152-155 More about this Journal
Abstract
Dural ateriovenous fistula (DAVF) at the craniocervical junction is rare. We report a patient presenting with brainstem dysfunction as an uncommon onset. Brainstem lesion was suggested by magnetic resonance image study. Angiogram revealed a DAVF at a high cervical segment supplied by the meningeal branch of the right vertebral artery, with ascending and descending venous drainage. Complete obliteration of the fistula was achieved via transarterial Onyx embolization. Clinical cure was achieved in the follow-up period; meanwhile, imaging abnormalities of this case disappeared. Accordingly, we hypothesize that a brainstem lesion of this case was caused by craniocervical DAVF, which induced venous hypertension. Thus, venous drainage patterns should be paid attention to because they are important for diagnosis and theraputic strategy.
Keywords
Dural arteriovenous fistula; Brainstem dysfunction; Diagnosis; Venous congestion;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Wu SL, Tsui HW, Chuang YC, Kuo HC, Chen CJ : Lumbar spinal dural arteriovenous fistula presenting with brainstem symptomatology : a case report. Acta Radiol 47 : 730-732, 2006   DOI
2 Kulwin C, Bohnstedt BN, Scott JA, Cohen-Gadol A : Dural arteriovenous fistulas presenting with brainstem dysfunction : diagnosis and surgical treatment. Neurosurg Focus 32 : E10, 2012
3 Lin CH, Lo YK, Lin YT, Li JY, Lai PH, Gau YY : Central vasomotor failure in a patient with medulla arteriovenous fistula. Acta Neurol Taiwan 15 : 192-196, 2006
4 Murata H, Kubota T, Murai M, Kanno H, Fujii S, Yamamoto I : Brainstem congestion caused by direct carotid-cavernous fistula--case report. Neurol Med Chir (Tokyo) 43 : 255-258, 2003   DOI
5 Park KW, Park SI, Im SB, Kim BT : Spinal dural arteriovenous fistula with supply from the lateral sacral artery-case report and review of literature-. J Korean Neurosurg Soc 45 : 115-117, 2009   DOI
6 Rhoton AL Jr : The posterior fossa veins. Neurosurgery 47 (3 Suppl) : S69-S92, 2000   DOI
7 Shintani S, Tsuruoka S, Shiigai T : Carotid-cavernous fistula with brainstem congestion mimicking tumor on MRI. Neurology 55 : 1929-1931, 2000   DOI
8 Takahashi S, Tomura N, Watarai J, Mizoi K, Manabe H : Dural arteriovenous fistula of the cavernous sinus with venous congestion of the brain stem : report of two cases. AJNR Am J Neuroradiol 20 : 886-888, 1999
9 Teng MM, Chang T, Pan DH, Chang CN, Huang CI, Guo WY, et al. : Brainstem edema : an unusual complication of carotid cavernous fistula. AJNR Am J Neuroradiol 12 : 139-142, 1991
10 Terao T, Taniguchi M, Ide K, Shinozaki M, Takahashi H : Cervical dural arteriovenous fistula presenting with brainstem dysfunction : case report and review. Spine (Phila Pa 1976) 31 : E722-E727, 2006   DOI
11 Chen G, Wang Q, Tian Y, Gu Y, Xu B, Leng B, et al. : Dural arteriovenous fistulae at the craniocervical junction : the relation between clinical symptom and pattern of venous drainage. Acta Neurochir Suppl 110 (Pt 2) : 99-104, 2011
12 Fassett DR, Rammos SK, Patel P, Parikh H, Couldwell WT : Intracranial subarachnoid hemorrhage resulting from cervical spine dural arteriovenous fistulas : literature review and case presentation. Neurosurg Focus 26 : E4, 2009
13 Guo LM, Zhou HY, Xu JW, Wang GS, Tian X, Wang Y, et al. : Dural arteriovenous fistula at the foramen magnum presenting with subarachnoid hemorrhage : case reports and literature review. Eur J Neurol 17 : 684-691, 2010   DOI
14 Hamada J, Yano S, Kai Y, Koga K, Morioka M, Ishimaru Y, et al. : Histopathological study of venous aneurysms in patients with dural arteriovenous fistulas. J Neurosurg 92 : 1023-1027, 2000   DOI   ScienceOn
15 Kai Y, Hamada JI, Morioka M, Yano S, Ushio Y : Brain stem venous congestion due to dural arteriovenous fistulas of the cavernous sinus. Acta Neurochir (Wien) 146 : 1107-1111; discussion 1111-1112, 2004   DOI
16 Iwasaki M, Murakami K, Tomita T, Numagami Y, Nishijima M : Cavernous sinus dural arteriovenous fistula complicated by pontine venous congestion. A case report. Surg Neurol 65 : 516-518; discussion 519, 2006   DOI
17 Jellema K, Tijssen CC, van Gijn J : Spinal dural arteriovenous fistulas : a congestive myelopathy that initially mimics a peripheral nerve disorder. Brain 129 (Pt 12) : 3150-3164, 2006   DOI   ScienceOn
18 Kai Y, Hamada J, Morioka M, Yano S, Mizuno T, Kuratsu J : Arteriovenous fistulas at the cervicomedullary junction presenting with subarachnoid hemorrhage : six case reports with special reference to the angiographic pattern of venous drainage. AJNR Am J Neuroradiol 26 : 1949-1954, 2005
19 Bussière M, Lownie SP, Pelz DM, Nicolle D : Direct carotid-cavernous fistula causing brainstem venous congestion. J Neuroophthalmol 29 : 21-25, 2009   DOI
20 Stiefel MF, Albuquerque FC, Park MS, Dashti SR, McDougall CG : Endovascular treatment of intracranial dural arteriovenous fistulae using Onyx : a case series. Neurosurgery 65 (6 Suppl) : 132-139; discussion 139-140, 2009   DOI   ScienceOn