title: Retrograde leptomeningeal venous approach for dural arteriovenous fistulas at foramen magnum.
abstract: A 72-year-old man presented with sudden right homonymous hemianopsia. Work-up imaging revealed a left occipital haematoma and an arteriovenous fistula supplied by the meningeal branches to the clivus from the left vertebral artery (VA) with a rostral venous reflux into cortical veins. A microcatheter was advanced through brainstem veins into the venous collector. A compliant balloon was placed in the left VA facing the origin of feeders. The balloon was inflated to protect the vertebrobasilar circulation from embolic migration. Onyx was injected by the transvenous catheter. Control angiogram revealed exclusion of the lesion. Informed consent was obtained from the patient.
authors.affiliation: Department of Interventional Neuroradiology, University of Limoges, France george_mendes@icloud.com.
authors.forename: George Ac
authors.initials: GA
authors.lastname: Mendes
authors.affiliation: Department of Neurological Surgery, University of Limoges, France.
authors.forename: François
authors.initials: F
authors.lastname: Caire
authors.affiliation: Department of Interventional Neuroradiology, University of Limoges, France.
authors.forename: Suzana
authors.initials: S
authors.lastname: Saleme
authors.affiliation: Department of Interventional Neuroradiology, University of Limoges, France.
authors.forename: Sanita
authors.initials: S
authors.lastname: Ponomarjova
authors.affiliation: Department of Interventional Neuroradiology, University of Limoges, France.
authors.forename: Charbel
authors.initials: C
authors.lastname: Mounayer
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D020785:Central Nervous System Vascular Malformations / Q000628:therapy*; D002533:Cerebral Angiography; D004121:Dimethyl Sulfoxide; D004621:Embolization, Therapeutic / Q000379:methods*; D005539:Foramen Magnum; D006423:Hemianopsia / Q000209:etiology; D006801:Humans; D008297:Male; D008578:Meninges; D011145:Polyvinyls; D011182:Postoperative Care; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide
keywords: Occipital haematoma; embolisation; foramen magnum fistulas; leptomeningeal veins; transvenous