title: Dural arteriovenous fistulas presenting with brainstem dysfunction: diagnosis and surgical treatment.
abstract: A cerebral dural arteriovenous fistula (DAVF) is an acquired abnormal arterial-to-venous connection within the leaves of the intracranial dura with a wide range of clinical presentations and natural history. The Cognard classification correlates venous drainage patterns with neurological course, identifying 5 DAVF types with increasing rates of symptomatic presentation. A spinal DAVF occurs when a radicular artery makes a direct anomalous shunt with a radicular vein within the dural leaflets of the nerve root sleeve. A cervical DAVF is a rare entity, as most spinal DAVFs present as thoracolumbar lesions with myelopathy. In this paper the authors present 2 patients presenting initially with brainstem dysfunction rather than myelopathy secondary to craniocervical DAVF. The literature is then reviewed for similar rare aggressive DAVFs at the craniocervical junction presenting with brainstem symptomatology.
authors.affiliation: Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, Indianapolis, Indiana 46202, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Kulwin
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Bohnstedt
authors.forename: John A
authors.initials: JA
authors.lastname: Scott
authors.forename: Aaron
authors.initials: A
authors.lastname: Cohen-Gadol
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D001933:Brain Stem / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis* / Q000601:surgery*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009493:Neurosurgery / Q000379:methods*