Document Detail

Angiographically occult epidural arteriovenous fistula of the craniocervical junction.
MedLine Citation:
PMID:  12009541     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Spinal dural and intradural arteriovenous fistulas (AVFs) have been the subject of numerous reports but purely epidural AVFs causing venous congestion within the spinal cord are rare. CASE DESCRIPTION: We describe a patient with an exclusively epidural arteriovenous fistula and congestive myelopathy. There are three interesting features of this case as described below: 1) The presence of a purely epidural AVF of the cranio-cervical junction. According to our knowledge this is the first case of an AVF in this location. 2) The lesion was angiographically occult. This was probably because of the extremely slow flow of the fistula. 3) Despite the negative angiograms, exploratory surgery was conducted because of positive clinical and MR findings. CONCLUSIONS: Epidural AVF/AVM of the foramen magnum should be considered in the differential diagnosis in patients with chronic myelopathy, even if cranial and spinal angiograms are negative. In these cases, we recommend that if clinical and radiological investigations strongly suggest the presence of an arteriovenous fistula, surgical exploration should be performed.
Servet Inci; Vural Bertan; Aysenur Cila
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  57     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-05-15     Completed Date:  2002-06-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  167-73; discussion 173     Citation Subset:  IM    
Department of Neurosurgery, School of Medicine, University of Hacettepe, Ankara, Turkey.
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MeSH Terms
Arteriovenous Fistula / complications,  radiography*,  surgery
Cervical Vertebrae / blood supply*,  radiography*,  surgery
Epidural Space / blood supply,  radiography*,  surgery
Skull / blood supply*,  radiography*,  surgery
Spinal Cord Diseases / etiology,  radiography*,  surgery

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