Endovascular treatment resolves non-hemorrhagic brainstem dysfunction due to tentorial dural AV fistula

J Clin Neurosci. 2009 Feb;16(2):317-20. doi: 10.1016/j.jocn.2008.02.022. Epub 2008 Dec 16.

Abstract

Tentorial dural arteriovenous fistulas (tDAVF) clinically present usually with subarachnoid and/or intraparenchymal hemorrhage. Reported rates range from 58% to 92% and neurological deficits occur in 79% to 92% of patients. This is due to venous congestion resulting from retrograde leptomeningeal venous drainage, which rarely, can be clinically silent. A 69-year-old woman presented with vertigo, double vision and gait instability. Cerebral digital subtraction angiography revealed a tDAVF with retrograde cerebellar venous drainage directed through the vein of Galen into the straight sinus. MRI showed extensive cerebellar edema due to venous congestion. Clinical manifestations of cerebellar and brainstem dysfunction resolved completely after transarterial embolization with N-butylcyanoacrylate.

Publication types

  • Case Reports
  • Technical Report

MeSH terms

  • Aged
  • Brain Injuries* / etiology
  • Brain Injuries* / pathology
  • Brain Injuries* / surgery
  • Brain Stem / pathology
  • Brain Stem / surgery*
  • Central Nervous System Vascular Malformations / complications*
  • Coronary Angiography / methods
  • Embolization, Therapeutic*
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods