title: Complex arteriovenous fistulas at C1 causing hematomyelia through aneurysmal rupture of a feeder from the anterior spinal artery.
abstract: A 64-year-old woman presented with left occipital headache and right dissociated sensory loss due to hematomyelia on the left ventral side of C1 caused by rupture of an aneurysm on one of the feeders extending from the anterior spinal artery to complex epidural or dural and intradural arteriovenous fistulas (AVFs). Branches from the left occipital and ascending pharyngeal arteries and those from the left C2 radicular, left posterior spinal and anterior spinal arteries formed these multiple shunts, linking with a common venous drain flowing into the right petrosal vein. Surgical interception of all the shunts was achieved, making it unnecessary to directly treat the aneurysm in the spinal cord. The feeders, aneurysm and AVFs were not visualized on postoperative angiography, and the patient returned to a normal working life.
authors: Department of Neurosurgery, Niigata Neurosurgical Hospital, 3057 Yamada, Niigata, Japan. kiyoshionda@apost.plala.or.jp
authors: Kiyoshi
authors: K
authors: Onda
authors: Yuichi
authors: Y
authors: Yoshida
authors: Hiroyuki
authors: H
authors: Arai
authors: Tomoaki
authors: T
authors: Terada
mesh_terms: D020759:Anterior Spinal Artery Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D013116:Spinal Cord / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology; D020758:Spinal Cord Vascular Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology