RT Journal Article
SR Electronic
T1 Dural Arteriovenous Fistulas: A Characteristic Pattern of Edema and Enhancement of the Medulla on MRI
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A5460
A1 A.Z. Copelan
A1 A. Krishnan
A1 H. Marin
A1 R. Silbergleit
YR 2018
UL http://www.ajnr.org/content/early/2017/12/07/ajnr.A5460.abstract
AB SUMMARY: Medullary edema with enhancement is rarely reported at initial MR imaging in intracranial dural arteriovenous fistulas. We report a series of 5 patients with dural arteriovenous fistulas, all of whom demonstrated a characteristic pattern of central medullary edema and medullary enhancement at initial MR imaging. Cognard type V dural arteriovenous fistula, defined by drainage into the perimedullary veins and the veins surrounding the brain stem, is a rare yet well-described pathologic entity. Even more rarely reported, however, is its clinical presentation with predominantly bulbar symptoms and MR imaging findings of central medullary edema with enhancement. This constellation of findings frequently leads to a convoluted clinical picture, prompting work-up for alternative disease processes and delaying diagnosis. Because an expedited diagnosis is critical in preventing poor outcomes, it is paramount to make the referring physician and neuroradiologist more cognizant of this rare-yet-characteristic imaging manifestation of dural arteriovenous fistula.DAVFdural arteriovenous fistula