雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Dural Arteriovenous Fistulas at the Craniocervical Junction Fed by Bilateral Vertebral Arteries with Intracranial Drainage: A Case Report Tomonori TAKESHITA 1 , Kentaro HAYASHI 1 , Naoki KITAGAWA 1 , Kazuhiko SUYAMA 1 , Izumi NAGATA 1 1Department of Neurosurgery,Nagasaki University School of Medicine Keyword: dural arteriovenous fistula , craniocervical junction , MRDSA pp.1229-1233
Published Date 2009/12/10
DOI https://doi.org/10.11477/mf.1436101074
  • Abstract
  • Look Inside
  • Reference

 We report a case of dural arteriovenous fistulas (DAVFs) at the craniocervical junction, which are supplied by the radicular arteries from bilateral vertebral arteries separately, and drainaged into intracranial sinuses. A 58-year-old man with intermittent neck pain visited our hospital. T2-weighted magnetic resonance (MR) imaging showed flow voids on the dorsal surface of the medulla and upper cervical cord without any signal changes suggesting ischemia. Postcontrast MR digital subtraction angiography (MRDSA) showed early venous filling at the craniocervical junction. Angiography demonstrated bilateral fistulas near each vertebral artery penetration point of the dura matter, which were drainaged into the superior and inferior petrosal sinuses. The patient underwent suboccipital craniotomy and laminectomy of the C1, then disruption of the bilateral fistulas was performed by using micro Doppler sonography after intradural exposure of the shunt points. His symptom subsided post operatively, and MRDSA showed no abnormal vessels. Angiography performed 1 week after surgery confirmed complete obliteration of the fistulas.

 DAVFs at the craniocervical junction fed by bilateral vertebral arteries is extremely rare. Even in such a case, direct interruption of the fistulas using micro Doppler sonography is the most effective treatment. In addition, MRDSA could be useful for screening and perioperative studies.


Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

関連文献

もっと見る

文献を共有