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CASE REPORT
Year : 2017  |  Volume : 50  |  Issue : 6  |  Page : 223-226

Craniocervical junction spinal dural arteriovenous fistula presenting with progressive myelopathy and sudden deterioration


1 Department of Surgery, Division of Neurosurgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
2 Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
3 Department of Medical Image, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
4 Department of Surgery, Division of Neurosurgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University; Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Correspondence Address:
Prof. Ann-Shung Lieu
No. 100, Tzyou 1st Road, Kaohsiung 807
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/fjs.fjs_98_17

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Spinal dura arteriovenous fistula (SDAVF) is not an uncommon vascular malformation but is rare at craniocervical junction. The initial presentation is usually subarachnoid hemorrhage or cervical myelopathy caused by venous hypertension of the drainage vein. We report a male patient who has sudden onset of paraplegia, anesthesia of bilateral lower limbs, and urine retention. Cervical spinal cord edema and engorgement of posterior and anterior spinal veins were noted on magnetic resonance image study. Angiogram disclosed a SDAVF feeding by meningeal branch of the left vertebral artery and drainage inferiorly through posterior and anterior spinal vein. Complete obliteration of the fistula was achieved by transarterial embolization with n-butyl cyanoacrylate. The muscle power of lower limbs improved after the embolization. In previous studies, functional outcome is most correlated with pretreatment condition. Early diagnosis and treatment of the lesion will prevent permanent neurological deficit.


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