[Cavernous arteriovenous fistula presenting myelopathy: a case report].
Intracranial dural arteriovenous fistula (DAVF) rarely presents with myelopathy. We discuss the diagnosis and treatment of this entity. A 76-year-old woman presented with tetraparesis and sphincter dysfunction. Magnetic resonance imaging demonstrated a high signal intensity from the medulla oblongata to the upper cervical cord on T2-weighted images. Angiograms showed a cavernous DAVF and venous drainage to perimedullary spinal veins via the petrosal vein. It was concluded that, myelopathy had resulted from congestion of the spinal veins. Transarterial embolization of the left cavernous sinus was performed through the left sphenopalatine artery with 25% NBCA after another feeding artery had been occluded using fiber coils. The patient's tetraparesis and sphincter dysfunction gradually improved after embolization, while the high signal intensity on T2-weighted images disappeared within two months after treatment. We should take intracranial DAVF into consideration in patients with myelopathy of unknown origin.
Ohnishi
Hiroyuki
H
Department of Neurosurgery, Osaka Medical College, 2-7 Daigaku-cho, Takatuki-city, Osaka 569-8686, Japan. neu086@poh.osaka-med.ac.jp
Deguchi
Jun
J
Yamada
Makoto
M
Kuroiwa
Toshihiko
T
D000368:Aged; D002426:Cavernous Sinus / Q000002:abnormalities* / Q000000981:diagnostic imaging; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000175:diagnosis; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology*