Intracranial dural fistulas with exclusive perimedullary drainage: the need for complete cerebral angiography for diagnosis and treatment planning.
Three patients are presented with slowly progressive tetraparesis caused by an intracranial dural arteriovenous fistula with exclusive perimedullary venous drainage. MR imaging showed a swollen cervicothoracic cord with central myelopathy and dilated perimedullary veins. Bilateral vertebral angiography initially failed to demonstrate the fistulas, and diagnosis was established with external carotid angiography. All 3 patients were successfully treated with glue embolization, 1 after failed surgical exploration. Angiographic cure of the fistula resulted in clinical cure in 1 patient and stabilization in 2 patients.
van Rooij
W J
WJ
Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, The Netherlands. radiol@knmg.nl
Sluzewski
M
M
Beute
G N
GN
D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D002533:Cerebral Angiography; D002550:Cerebral Veins; D002560:Cerebrovascular Circulation; D004487:Edema / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy