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Obliteration of a tentorial dural arteriovenous fistula causing spinal cord myelopathy using the cranio-orbito zygomatic approach.
Surg Neurol. 2004 Nov; 62(5):463-7; discussion 467.SN

Abstract

BACKGROUND

Intracranial dural arteriovenous fistulas account for 10 to 15% of all intracranial arteriovenous malformations. Tentorial dural arteriovenous fistulas with spinal medullary venous drainage causing spinal cord myelopathy are very rare, but have been previously described. We describe a case using a cranio-orbito zygomatic approach with intraoperative angiography for the surgical treatment of a tentorial artery dural arteriovenous fistula causing spinal cord myelopathy.

CASE PRESENTATION

A 42-year-old male presented complaining of a 1-year history of incoordination and dizziness and a 2-month history of progressive myelopathy with bowel and bladder incontinence. The patient had magnetic resonance imaging (MRI) performed along with cerebral and spinal angiography that revealed a right tentorial artery dural arteriovenous fistula with spinal medullary venous involvement down to T11. Angiographic embolization was attempted, but selective catheterization was unsuccessful. The patient underwent a cranio-orbito zygomatic approach with obliteration of the dural arteriovenous fistula. An intraoperative angiogram confirmed complete obliteration of the dural arteriovenous fistula.

CONCLUSION

Intracranial dural arteriovenous fistulas are a rare cause of spinal cord myelopathy. When a patient presents with suspicion of spinal dural fistula and negative spinal angiography, an intracranial origin should be suspected and a cerebral angiogram performed. Skull base approaches along with intraoperative angiography provide an alternative modality for obliteration of the dural arteriovenous fistula nidus, thereby eliminating the venous congestion and hence the spinal cord ischemia.

Authors+Show Affiliations

Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15518860

Citation

Pannu, Yash, et al. "Obliteration of a Tentorial Dural Arteriovenous Fistula Causing Spinal Cord Myelopathy Using the Cranio-orbito Zygomatic Approach." Surgical Neurology, vol. 62, no. 5, 2004, pp. 463-7; discussion 467.
Pannu Y, Shownkeen H, Nockels RP, et al. Obliteration of a tentorial dural arteriovenous fistula causing spinal cord myelopathy using the cranio-orbito zygomatic approach. Surg Neurol. 2004;62(5):463-7; discussion 467.
Pannu, Y., Shownkeen, H., Nockels, R. P., & Origitano, T. C. (2004). Obliteration of a tentorial dural arteriovenous fistula causing spinal cord myelopathy using the cranio-orbito zygomatic approach. Surgical Neurology, 62(5), 463-7; discussion 467.
Pannu Y, et al. Obliteration of a Tentorial Dural Arteriovenous Fistula Causing Spinal Cord Myelopathy Using the Cranio-orbito Zygomatic Approach. Surg Neurol. 2004;62(5):463-7; discussion 467. PubMed PMID: 15518860.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obliteration of a tentorial dural arteriovenous fistula causing spinal cord myelopathy using the cranio-orbito zygomatic approach. AU - Pannu,Yash, AU - Shownkeen,Harish, AU - Nockels,Russ P, AU - Origitano,T C, PY - 2003/06/02/received PY - 2004/01/07/accepted PY - 2004/11/3/pubmed PY - 2004/11/17/medline PY - 2004/11/3/entrez SP - 463-7; discussion 467 JF - Surgical neurology JO - Surg Neurol VL - 62 IS - 5 N2 - BACKGROUND: Intracranial dural arteriovenous fistulas account for 10 to 15% of all intracranial arteriovenous malformations. Tentorial dural arteriovenous fistulas with spinal medullary venous drainage causing spinal cord myelopathy are very rare, but have been previously described. We describe a case using a cranio-orbito zygomatic approach with intraoperative angiography for the surgical treatment of a tentorial artery dural arteriovenous fistula causing spinal cord myelopathy. CASE PRESENTATION: A 42-year-old male presented complaining of a 1-year history of incoordination and dizziness and a 2-month history of progressive myelopathy with bowel and bladder incontinence. The patient had magnetic resonance imaging (MRI) performed along with cerebral and spinal angiography that revealed a right tentorial artery dural arteriovenous fistula with spinal medullary venous involvement down to T11. Angiographic embolization was attempted, but selective catheterization was unsuccessful. The patient underwent a cranio-orbito zygomatic approach with obliteration of the dural arteriovenous fistula. An intraoperative angiogram confirmed complete obliteration of the dural arteriovenous fistula. CONCLUSION: Intracranial dural arteriovenous fistulas are a rare cause of spinal cord myelopathy. When a patient presents with suspicion of spinal dural fistula and negative spinal angiography, an intracranial origin should be suspected and a cerebral angiogram performed. Skull base approaches along with intraoperative angiography provide an alternative modality for obliteration of the dural arteriovenous fistula nidus, thereby eliminating the venous congestion and hence the spinal cord ischemia. SN - 0090-3019 UR - https://www.unboundmedicine.com/medline/citation/15518860/Obliteration_of_a_tentorial_dural_arteriovenous_fistula_causing_spinal_cord_myelopathy_using_the_cranio_orbito_zygomatic_approach_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090301904001314 DB - PRIME DP - Unbound Medicine ER -