Document Detail


Brain stem ischemia from intracranial dural arteriovenous fistula: case report.
MedLine Citation:
PMID:  16231425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intracranial dural arteriovenous fistulas (AVFs) with spinal perimedullary venous drainage are rarely reported, but most of the patients initially have presented with myelopathy or subarachnoid hemorrhage. This is the first report of the intracranial dural AVF patient who presented with brain stem infarction. CASE DESCRIPTION: A 38-year-old woman experienced nausea and vomiting with an acute onset, followed by vertigo. Magnetic resonance imaging showed ischemic lesion in the medulla oblongata, and she was then sent to our hospital. On admission, she had nystagmus, swallowing difficulties, Homer syndrome, and right hemiparesis and hemisensory disturbance. Cerebral angiography revealed dural AVF draining into spinal perimedullary veins at the left transverse-sigmoid sinus. The patient was treated by transvenous embolization under local anesthesia. A microcatheter proceeded to the left sigmoid sinus via the internal jugular vein, and embolization of the sinus was performed using coils without complications. The patient's swallowing difficulties improved over a few days after the embolization, and one month later, there remained only a slight mild hemiparesis and hemisensory disturbance. Six months after the onset, there was no ischemic lesion in the brain stem on magnetic resonance imaging. CONCLUSIONS: In this case, we showed the possibility of brain stem infarction, caused by the intracranial dural AVF.
Authors:
Motoyoshi Satoh; Mitsuo Kuriyama; Takashi Fujiwara; Koji Tokunaga; Kenji Sugiu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  64     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-18     Completed Date:  2005-11-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  341-5; discussion 345     Citation Subset:  IM    
Affiliation:
Departmrnt of Neurological Surgery, Kure Kyosai Hospital, Kure, Hiroshima 737-8505, Japan. motoyoshisato@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain Ischemia / etiology,  physiopathology,  surgery*
Brain Stem Infarctions / etiology,  physiopathology,  surgery*
Cerebral Angiography
Cranial Sinuses / pathology*,  physiopathology,  surgery*
Embolization, Therapeutic / methods
Female
Humans
Intracranial Arteriovenous Malformations / pathology*,  radiography,  surgery*
Lateral Medullary Syndrome / etiology,  physiopathology,  surgery
Magnetic Resonance Imaging
Medulla Oblongata / blood supply,  pathology,  physiopathology
Neurosurgical Procedures / methods
Prostheses and Implants
Spinal Cord / blood supply
Treatment Outcome
Vascular Surgical Procedures / methods

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