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[Characteristics and treatment of dural and perimedullary arteriovenous fistula at the craniocervical junction presenting with subarachnoid hemorrhage].
No Shinkei Geka. 2012 Feb; 40(2):121-8.NS

Abstract

Dural and perimedullary arteriovenous fistula (AVF) at the craniocervical junction tend to cause subarachnoid hemorrhage (SAH). However, their natural history and clinical manifestations still remain to be elucidated. From 2003 to 2009, we encountered 5 cases of dural and perimedullary AVF presented with SAH. They were all male, ranging in age from 53 to 85 year-old (mean: 68 year-old). Rebleeding occurred in 1 patient on day 11. Outcome estimated by modified Rankin Scale did not change remarkably from 2.6 on admission to 2.4 at 3 months later on average. Cerebral angiography and 3D-CT angiography disclosed feeders originating from radicular or intracranial vertebral arteries which drained into the epidural venous plexus or spinal meningeal veins. One patient died of systemic complication during his clinical course. Thus we performed open surgery in the remaining 4 patients. Of these, we failed to occlude feeders completely in the initial surgery without intraoperative digital subtraction angiography (DSA) in 2 patients. Following this treatment we performed coil embolization and repeated open surgery with the aid of intraoperative DSA, respectively. In 1 patient out of the remaining 2 patients, we utilized intraoperative DSA to confirm complete disappearance of AVF composed of multiple feeders. These observations show that SAH caused by dural and perimedullary AVF at the craniocervical junction should be mainly treated by open surgery with the aid of intraoperative DSA in order to accomplish obliteration of the feeders because, otherwise, we might fail to confirm complete disappearance of AVF.

Authors+Show Affiliations

Department of Neurosurgery, Teikyo University School of Medicine, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

22281464

Citation

Ogawa, Akiko, et al. "[Characteristics and Treatment of Dural and Perimedullary Arteriovenous Fistula at the Craniocervical Junction Presenting With Subarachnoid Hemorrhage]." No Shinkei Geka. Neurological Surgery, vol. 40, no. 2, 2012, pp. 121-8.
Ogawa A, Furuya K, Ueno T, et al. [Characteristics and treatment of dural and perimedullary arteriovenous fistula at the craniocervical junction presenting with subarachnoid hemorrhage]. No Shinkei Geka. 2012;40(2):121-8.
Ogawa, A., Furuya, K., Ueno, T., Naito, Y., & Nakagomi, T. (2012). [Characteristics and treatment of dural and perimedullary arteriovenous fistula at the craniocervical junction presenting with subarachnoid hemorrhage]. No Shinkei Geka. Neurological Surgery, 40(2), 121-8.
Ogawa A, et al. [Characteristics and Treatment of Dural and Perimedullary Arteriovenous Fistula at the Craniocervical Junction Presenting With Subarachnoid Hemorrhage]. No Shinkei Geka. 2012;40(2):121-8. PubMed PMID: 22281464.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Characteristics and treatment of dural and perimedullary arteriovenous fistula at the craniocervical junction presenting with subarachnoid hemorrhage]. AU - Ogawa,Akiko, AU - Furuya,Kazuhide, AU - Ueno,Toshiaki, AU - Naito,Yuichiro, AU - Nakagomi,Tadayoshi, PY - 2012/1/28/entrez PY - 2012/1/28/pubmed PY - 2012/4/11/medline SP - 121 EP - 8 JF - No shinkei geka. Neurological surgery JO - No Shinkei Geka VL - 40 IS - 2 N2 - Dural and perimedullary arteriovenous fistula (AVF) at the craniocervical junction tend to cause subarachnoid hemorrhage (SAH). However, their natural history and clinical manifestations still remain to be elucidated. From 2003 to 2009, we encountered 5 cases of dural and perimedullary AVF presented with SAH. They were all male, ranging in age from 53 to 85 year-old (mean: 68 year-old). Rebleeding occurred in 1 patient on day 11. Outcome estimated by modified Rankin Scale did not change remarkably from 2.6 on admission to 2.4 at 3 months later on average. Cerebral angiography and 3D-CT angiography disclosed feeders originating from radicular or intracranial vertebral arteries which drained into the epidural venous plexus or spinal meningeal veins. One patient died of systemic complication during his clinical course. Thus we performed open surgery in the remaining 4 patients. Of these, we failed to occlude feeders completely in the initial surgery without intraoperative digital subtraction angiography (DSA) in 2 patients. Following this treatment we performed coil embolization and repeated open surgery with the aid of intraoperative DSA, respectively. In 1 patient out of the remaining 2 patients, we utilized intraoperative DSA to confirm complete disappearance of AVF composed of multiple feeders. These observations show that SAH caused by dural and perimedullary AVF at the craniocervical junction should be mainly treated by open surgery with the aid of intraoperative DSA in order to accomplish obliteration of the feeders because, otherwise, we might fail to confirm complete disappearance of AVF. SN - 0301-2603 UR - https://www.unboundmedicine.com/medline/citation/22281464/[Characteristics_and_treatment_of_dural_and_perimedullary_arteriovenous_fistula_at_the_craniocervical_junction_presenting_with_subarachnoid_hemorrhage]_ L2 - https://webview.isho.jp/openurl?rft.genre=article&rft.issn=0301-2603&rft.volume=40&rft.issue=2&rft.spage=121 DB - PRIME DP - Unbound Medicine ER -