title: Coincidental vascular anomalies at the foramen magnum: dural arteriovenous fistula and high flow aneurysm on perimedullary fistula.
abstract: We report the case of a 59-year-old woman admitted for a sudden headache due to a subarachnoid haemorrhage. On CT scan, the clots predominated into the posterior fossa without high-density in the sylvian or interhemispheric fissures. The vertebral angiography revealed a dural arteriovenous fistula at the foramen magnum associated to an aneurysm of the cervical anterior spinal artery. Due to the high rebleeding risk of a dural shunt, we proposed curative treatment using microsurgical interruption of the intradural draining vein. On the postoperative angiography at 15-day follow-up, the 2 malformations were corrected and the outcome at 6 months was excellent. Based on the literature, we assess this exceptional association and suggest its possible management.
authors.affiliation: Department of neurosurgery, Rouen university hospital, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Gilard
authors.forename: S
authors.initials: S
authors.lastname: Curey
authors.forename: E
authors.initials: E
authors.lastname: Tollard
authors.forename: F
authors.initials: F
authors.lastname: Proust
mesh_terms: D000783:Aneurysm / Q000175:diagnosis / Q000601:surgery*; D000792:Angiography / Q000379:methods; D020785:Central Nervous System Vascular Malformations / Q000601:surgery*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005539:Foramen Magnum / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D013116:Spinal Cord / Q000098:blood supply; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Aneurysm; Anterior spinal artery; Anévrisme; Artère spinale antérieure; Craniocervical junction; Dural arteriovenous fistula; Fistule durale artério-veineuse; Hémorragie sous-arachnoidienne; Jonction craniocervicale; Subarachnoid haemorrhage