Advertisement

Acta Neurochirurgica

, Volume 154, Issue 3, pp 471–475 | Cite as

Complex arteriovenous fistulas at C1 causing hematomyelia through aneurysmal rupture of a feeder from the anterior spinal artery

  • Kiyoshi OndaEmail author
  • Yuichi Yoshida
  • Hiroyuki Arai
  • Tomoaki Terada
Case Report

Abstract

A 64-year-old woman presented with left occipital headache and right dissociated sensory loss due to hematomyelia on the left ventral side of C1 caused by rupture of an aneurysm on one of the feeders extending from the anterior spinal artery to complex epidural or dural and intradural arteriovenous fistulas (AVFs). Branches from the left occipital and ascending pharyngeal arteries and those from the left C2 radicular, left posterior spinal and anterior spinal arteries formed these multiple shunts, linking with a common venous drain flowing into the right petrosal vein. Surgical interception of all the shunts was achieved, making it unnecessary to directly treat the aneurysm in the spinal cord. The feeders, aneurysm and AVFs were not visualized on postoperative angiography, and the patient returned to a normal working life.

Keywords

Spinal arteriovenous fistula Feeder aneurysm Hematomyelia 

Notes

Conflicts of interest

None.

References

  1. 1.
    Barrow DL, Boyer KL, Joseph GJ (1992) Intraoperative angiography in the management of neurovascular disorders. Neurosurgery 30:153–159PubMedCrossRefGoogle Scholar
  2. 2.
    Biondi A, Merland JJ, Hodes JE, Pruvo JP, Reizine D (1992) Aneurysms of spinal arteries associated with intramedullary arteriovenous malformations I. Angiographic and clinical aspect. AJNR Am J Neuroradiol 13:913–922PubMedGoogle Scholar
  3. 3.
    Garcia-Monaco R, Rodesch G, Terbrugge K, Burrows P, Lasjaunias P (1991) Multifocal dural arteriovenous shunts in children. Child’s Nerv Syst 7:425–431CrossRefGoogle Scholar
  4. 4.
    Geibprasert S, Pereira V, Krings T, Jiarakongmun P, Toulgoat F, Pongpech S, Lasjaunias P (2008) Dural arteriovenous shunts. A new classification of craniospinal epidural venous anatomical bases and clinical correlations. Stroke 39:2783–2794PubMedCrossRefGoogle Scholar
  5. 5.
    Gueguen B, Merland JJ, Riche MC, Rey A (1987) Vascular malformations of the spinal cord: intrathecal perimedullary arteriovenous fistulas fed by medullary arteries. Neurology 37:969–979PubMedGoogle Scholar
  6. 6.
    Halbach VV, Higashida RT, Dowd CF, Fraser KW, Edwards MS, Barnwell SL (1993) Treatment of giant intradural (perimedullary) arteriovenous fistulas. Neurosurgery 33:972–980PubMedCrossRefGoogle Scholar
  7. 7.
    Krings T, Coenen VA, Weinzierl M, Reinges MHT, Mull M, Thron A, Rohde V (2006) Spinal dural arteriovenous fistula associated with a spinal perimedullary fistula. Case report. J Neurosurg Spine 4:241–245PubMedCrossRefGoogle Scholar
  8. 8.
    Levy WJ (1987) Clinical experience with motor and cerebellar evoked potential monitoring. Neurosurgery 20:169–182PubMedGoogle Scholar
  9. 9.
    Matsui T, Taniguchi T, Saitoh T, Kamijoh K, Nakamura T, Yamashita A, Takayanagi S, Sakamoto M, Ishikawa T (2007) Hematomyelia caused by ruptured intramedullary spinal artery aneurysm associated with extramedullary spinal arteriovenous fistula—case report. Neurol Med Chir (Tokyo) 47:233–236CrossRefGoogle Scholar
  10. 10.
    Mourier KL, Gobin YP, George B, Lot G, Merland JJ (1993) Intradural perimedullary arteriovenous fistulae: results of surgical and endovascular treatment in a series of 35 cases. Neurosurgery 32:885–891PubMedCrossRefGoogle Scholar
  11. 11.
    O’Toole JE, McCormick PC (2011) Vascular malformation of the spinal cord. In: Herkowitz HN, Garfin SR, Eismont FJ, Bell GR, Balderston RA (eds) Rothman-Simeone The Spine, 6th edn. Elsevier Saunders, Philadelphia, pp 1642–1654Google Scholar
  12. 12.
    Patsalides A, Knopman J, Santillan A, Tsiouris AJ, Riina H, Gobin YP (2010) Endovascular treatment of spinal arteriovenous lesions: beyond the dural fistula. AJNR Am J Neuroradiol 32:798–808Google Scholar
  13. 13.
    Rodesch G, Lasjaunias P (2003) Spinal cord arteriovenous shunts: from imaging to management. Eur J Radiol 46:221–232PubMedCrossRefGoogle Scholar
  14. 14.
    Rodesch G, Hurth M, Alvarez H, Tadié M, Lasjaunias P (2002) Classification of spinal cord arteriovenous shunts: proposal for a reappraisal—the Bicêtre experience with 155 consecutive patients treated beteween 1981 and 1999. Neurosurgery 51:374–380PubMedGoogle Scholar
  15. 15.
    Spetzler RF, Detwiler PW, Riina HA, Porter RW (2002) Modified classification of spinal cord vascular lesions. J Neurosurg Spine 96:145–156CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Kiyoshi Onda
    • 1
    Email author
  • Yuichi Yoshida
    • 1
  • Hiroyuki Arai
    • 1
  • Tomoaki Terada
    • 2
  1. 1.Department of NeurosurgeryNiigata Neurosurgical HospitalNiigataJapan
  2. 2.Department of NeurosurgeryWakayama Rosai HospitalWakayamaJapan

Personalised recommendations