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A Case of Cervical Spinal Dural Arteriovenous Fistula with Extradural Drainage Presenting with Subarachnoid Hemorrhage due to a Ruptured Anterior Spinal Artery Aneurysm Yasuharu KUROKAWA 1 , Fusao IKAWA 1 , Osamu HAMASAKI 1 , Toshikazu HIDAKA 1 , Ushio YONEZAWA 1 , Masaki KOMIYAMA 2 1Department of Neurosurgery, Shimane Prefectural Central Hospital 2Department of Neurosurgery, Osaka City General Hospital Keyword: cervical dural arteriovenous fistula , anterior spinal artery aneurysm , subarachnoid hemorrhage , extradural drainage pp.803-811
Published Date 2015/9/10
DOI https://doi.org/10.11477/mf.1436203125
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 We report a rare case of a cervical spinal dural arteriovenous fistula(AVF)at the C2 level presenting with subarachnoid hemorrhage(SAH)due to a ruptured anterior spinal artery aneurysm. A 61-year-old man presented with sudden onset headache. Initial computed tomography revealed SAH around the brainstem. Digital subtraction angiography(DSA)demonstrated a cervical dural AVF that was fed by the left C1 radicular, left C2 radicular, and anterior spinal arteries, and drained into the epidural plexus. An aneurysm in the branch of the cervical anterior spinal artery was considered the bleeding point. A left lateral suboccipital craniotomy and C1 hemilaminectomy were performed on day 43. The feeding arteries were clipped, followed by coagulation of the draining veins. However, the aneurysm was not clipped because we deemed that obliteration of the aneurysm would be difficult without disrupting the blood flow of the parent artery. The patient showed no neurological deterioration after the operation. Postoperative DSA revealed residual dural AVF. Therefore, a second surgery was performed. After the second open surgery, DSA showed that the dural AVF and aneurysm disappeared. The patient also showed no neurological deterioration after the second surgery.


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

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