title: Bilateral cervical spinal dural arteriovenous fistulas with intracranial venous drainage mimicking a foramen magnum dural arteriovenous fistula.
abstract: We describe a unique case of bilateral cervical spinal dural arteriovenous fistulas mimicking an intracranial dural arteriovenous fistula near the foramen magnum. We review its detection via MRI and digital subtraction angiography and subsequent management through surgical intervention. Pitfalls in diagnostic angiography are discussed with reference to accurate location of the fistula site. The venous anastomotic connections of the posterior midline spinal vein to the medial posterior medullary vein, posterior fossa bridging veins, and dural venous sinuses of the skull base are discussed with reference to problem-solving in this complex case. The mechanism of myelopathy through venous hypertension produced by spinal dural fistulas is also emphasized.
authors.affiliation: Department of Radiology and Biomedical Imaging; University of California; San Francisco, CA, USA - Steven.Hetts@ucsf.edu.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Hetts
authors.forename: Joey D
authors.initials: JD
authors.lastname: English
authors.forename: Shirley I
authors.initials: SI
authors.lastname: Stiver
authors.forename: Vineeta
authors.initials: V
authors.lastname: Singh
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Yee
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Cooke
authors.forename: Van V
authors.initials: VV
authors.lastname: Halbach
mesh_terms: D000328:Adult; D020785:Central Nervous System Vascular Malformations / Q000473:pathology*; D002550:Cerebral Veins / Q000002:abnormalities* / Q000473:pathology*; D002574:Cervical Vertebrae / Q000473:pathology; D003937:Diagnosis, Differential; D005539:Foramen Magnum / Q000098:blood supply* / Q000000981:diagnostic imaging*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D011859:Radiography; D013116:Spinal Cord / Q000002:abnormalities / Q000098:blood supply* / Q000473:pathology
keywords: MR angiography; MR imaging; digital subtraction angiography; spinal angiography; spinal dural arteriovenous fistula; spine; vascular malformations