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American Journal of Neuroradiology 28:348-351, February 2007
© 2007 American Society of Neuroradiology

Case Report
INTERVENTIONAL

Intracranial Dural Fistulas with Exclusive Perimedullary Drainage: The Need for Complete Cerebral Angiography for Diagnosis and Treatment Planning

W.J. van Rooija, M. Sluzewskia and G.N. Beuteb

a Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands
b Department of Neurosurgery, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands

Please address correspondence to Willem Jan van Rooij, MD, PhD, Department of Radiology, St. Elisabeth Ziekenhuis, Hilvarenbeekseweg 60, 5022 GC Tilburg, the Netherlands; e-mail: radiol{at}knmg.nl

SUMMARY: Three patients are presented with slowly progressive tetraparesis caused by an intracranial dural arteriovenous fistula with exclusive perimedullary venous drainage. MR imaging showed a swollen cervicothoracic cord with central myelopathy and dilated perimedullary veins. Bilateral vertebral angiography initially failed to demonstrate the fistulas, and diagnosis was established with external carotid angiography. All 3 patients were successfully treated with glue embolization, 1 after failed surgical exploration. Angiographic cure of the fistula resulted in clinical cure in 1 patient and stabilization in 2 patients.






Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X