Endovascular therapy of hypoglossal canal AVFs presenting with orbital symptoms.
OBJECTIVE
Dural arteriovenous fistulae (DAVF) of the hypoglossal canal region are rare lesions. We describe three cases of DAVF of the hypoglossal canal presenting with ocular symptoms and discuss the endovascular management options.


METHODS
Three consecutive patients with DAVF of the hypoglossal canal region presented with proptosis, chemosis and disturbances of extra-ocular mobility. Each patient was treated using a different endovascular approach, based on variations of the vascular access.


RESULTS
The cases and treatments are reviewed, with a literature review on the subject. Endovascular treatment, transvenous or trans-arterial was curative in all cases.


CONCLUSIONS
DAVF of the hypoglossal canal region can present with ocular manifestations very similar to DAVF of the cavernous sinus or carotid-cavernous fistulas. Endovascular treatment is usually feasible and effective, but an understanding of the vascular anatomy and pathophysiology of the disease are of utmost importance when planning the approach.
Miropolsky
Vladislav
V
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
da Costa
Leodante B
LB
Marotta
Thomas R
TR
Spears
Julian
J
D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D020437:Hypoglossal Nerve Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D007601:Jugular Veins / Q000473:pathology; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009916:Orbital Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods