Highlights
- •DAVF of the craniocervical junction can have different venous drainage patterns.
- •The venous drainage can be inferior, superior or both.
- •The anatomy of the DAVF predicts the clinical presentation of the patient. Patients with superior drainage are more likely to present with a hemorrhage whereas patients with inferior drainage tend to present with myelopathy.
- •In our paper, we propose a novel classification system in which DAVF of the craniocervical junction can be grouped into three types and for each type, we present a treatment paradigm.
- •Microsurgery remains an effective treatment option. There is an emerging role of transvenous embolization particularly for superior draining DAVF.
Abstract
Background
Methods
Results
Conclusions
Keywords
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Subscribe to Journal of Clinical NeuroscienceReferences
- Spinal dural arteriovenous fistula: a review.Adv Tech Stand Neurosurg. 2016; : 111-137
- Natural history and treatment of craniocervical junction dural arteriovenous fistulas.J Clin Neurosci. 2015; 22: 1701-1707
- Angioarchitecture of arteriovenous fistulas at the craniocervical junction: a multicenter cohort study of 54 patients.J Neurosurg. 2018; 128: 1839-1849
- Long-term Outcome of Cervical and Thoracolumbar Dural Arteriovenous Fistulas With Emphasis on Sensory Disturbance and Neuropathic Pain.World Neurosurg. 2010; 73: 401-408
- Dural Arteriovenous Fistulas at the Craniocervical Junction: A Series Case Report.World Neurosurg. 2019; 122: e700-e712
- Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage.Radiology. 1995; 194: 671-680
- Dural arteriovenous fistulas at the craniocervical junction: a systematic review.J NeuroInterventional Surg. 2016; 8: 648-653
- Foramen magnum dural arteriovenous fistulae with repeated subarachnoid haemorrhage.Interv Neuroradiol. 1998; 4: 171-176
- Progressive Myelopathy Caused by Dural Arteriovenous Fistula at the Craniocervical Junction —Case Report&mdash.Neurol Med Chir. 1999; 39: 376-379
- Endovascular treatment for dural arteriovenous fistula at the foramen magnum: report of five consecutive patients and experience with balloon-augmented transarterial Onyx injection.J Neuroradiol. 2013; 40: 134-139
- Results of 1940 embolizations for dural arteriovenous fistulas: Japanese Registry of Neuroendovascular Therapy (JR-NET3).J Neurosurg. 2019; 133: 1-8
- Endovascular treatment for dural arteriovenous fistula.Brain Nerve. 2008; 60: 907-914
- Foramen magnum dural arteriovenous fistula treated by a microsurgical technique combined with a feeder occlusion using transarterial coil embolization.Turk Neurosurg. 2015; 25: 971-975
- Arteriovenous fistulas of the cervicomedullary junction as a cause of myelopathy: radiographic findings in two cases.AJNR Am J Neuroradiol. 1990; 11: 518-521
- The variable presentations of craniocervical and cervical dural arteriovenous malformations.Surg Neurol. 1990; 34: 118-123https://doi.org/10.1016/0090-3019(90)90107-Z
- Dural arteriovenous fistula at the craniocervical junction with perimedullary venous drainage.Am J Neuroradiol. 1996; 17: 1137-1141
- Transcondylar Approach for Dural Arteriovenous Fistulas of the Cervicomedullary Junction.Surg Neurol. 1997; 48: 627-631
- Dural arteriovenous shunts at the craniocervical junction.J Neurosurg. 1998; 89: 755-761https://doi.org/10.3171/jns.1998.89.5.0755
- Dural arteriovenous fistula of the cervical spine presenting with subarachnoid hemorrhage.Am J Neuroradiol. 1999; 20: 348-350
- Dural arteriovenous fistulas of the craniocervical junction.Skull Base Surg. 1999; 9: 1-7https://doi.org/10.1055/s-2008-1058166
- Successful surgical treatment of a dural arteriovenous fistula at the craniocervical junction with reference to pre- and postoperative MRI.Neuroradiology. 1999; 41: 463-467https://doi.org/10.1007/s002340050785
- Iida J-i, Shin Y, Hironaka Y, Sakaki T: Spinal dural arteriovenous fistula with perimesencephalic subarachnoid haemorrhage.J Clin Neurosci. 2000; 7: 64-66
- Dural arteriovenous fistulae at the foramen magnum.J Neurol. 2001; 248: 197-203https://doi.org/10.1007/s004150170226
- Posterior fossa hemorrhage caused by dural arteriovenous fistula: case reports.Surg Neurol. 2003; 59: 512-516https://doi.org/10.1016/S0090-3019(03)00077-6
- Microsurgical interruption of dural arteriovenous fistula at the foramen magnum.J Clin Neurosci. 2005; 12: 580-583
- Transarterial embolization of a cervical dural arteriovenous fistula. Presenting with subarachnoid hemorrhage.Interv Neuroradiol. 2006; 12: 313-318https://doi.org/10.1177/159101990601200404
- Occipital Neuralgia As a Presenting Symptom of Cervicomedullary Dural Arteriovenous Fistula.Headache: J Head Face Pain. 2007; 47: 1095-1097
- Intracranial subarachnoid hemorrhage resulting from cervical spine dural arteriovenous fistulas: literature review and case presentation.Neurosurg Focus FOC. 2009; 26: E4https://doi.org/10.3171/FOC.2009.26.1.E4
- Dural arteriovenous fistula at the foramen magnum presenting with subarachnoid hemorrhage: case reports and literature review.Eur J Neurol. 2010; 17: 684-691
Chen G, Wang Q Fau - Tian Y, Tian Y Fau - Gu Y, et al.: Dural arteriovenous fistulae at the craniocervical junction: the relation between clinical symptom and pattern of venous drainage; 2011.
- Intraoperative indocyanine green angiography for microsurgical treatment of a craniocervical dural arteriovenous fistula.Clin Neurol Neurosurg. 2012; 114: 696-698
- Dural arteriovenous fistulas presenting with brainstem dysfunction: diagnosis and surgical treatment.Neurosurgical Focus FOC. 2012; 32: E10https://doi.org/10.3171/2012.2.FOCUS1217
- A Case of Dural Arteriovenous Fistulas at the Craniocervical Junction Presenting with Occipital/Neck Pain Associated with Sleep.Intern Med. 2012; 51: 925-928
- Dural Arteriovenous Fistula at the Craniocervical Junction Mimicking Acute Brainstem and Spinal Cord Infarction.JAMA Neurol. 2013; 70: 796https://doi.org/10.1001/jamaneurol.2013.1946
- Brainstem Congestion due to Dural Ateriovenous Fistula at the Craniocervical Junction.J Korean Neurosurg Soc. 2014; 55: 152-155https://doi.org/10.3340/jkns.2014.55.3.152
- Foramen magnum dural arteriovenous fistula presenting with epilepsy.Interv Neuroradiol. 2015; 21: 724-727https://doi.org/10.1177/1591019915609783
- High cervical spinal subdural hemorrhage as a harbinger of craniocervical arteriovenous fistula: an unusual clinical presentation.Spine J. 2015; 15: e13-e17https://doi.org/10.1016/j.spinee.2015.02.035
- Dural arteriovenous fistula of the craniocervical junction manifesting as cerebellar haemorrhage.Neuroradiol J. 2016; 29: 356-360https://doi.org/10.1177/1971400916665374
- The Long and Winding Road: Thoracic Myelopathy Associated With Occipitocervical Dural Arteriovenous Fistula.World Neurosurg. 2017; 108: 998https://doi.org/10.1016/j.wneu.2017.09.073
- Dural arteriovenous fistula manifesting as pontine hemorrhage at the craniocervical junction.Acta Neurochir. 2017; 159: 831-834https://doi.org/10.1007/s00701-017-3135-y
- Remote Thoracic Myelopathy From a Spinal Dural Arteriovenous Fistula at the Craniocervical Junction: Case Report and Review of Literature.World Neurosurg. 2017; 108: 992.e991-992.e994https://doi.org/10.1016/j.wneu.2017.08.158
- “Black butterfly” sign on T2*-weighted and susceptibility-weighted imaging: A novel finding of chronic venous congestion of the brain stem and spinal cord associated with dural arteriovenous fistulas.J Neurol Sci. 2017; 379: 64-68https://doi.org/10.1016/j.jns.2017.05.066
- Acute Tetraparesis with Respiratory Failure after Steroid Administration in a Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction.Intern Med. 2018; 57: 591-594https://doi.org/10.2169/internalmedicine.9115-17
- Brainstem Congestion Due to Dural Arteriovenous Fistula at the Craniocervical Junction: Case Report and Review of the Literature.World Neurosurg. 2018; 118: 181https://doi.org/10.1016/j.wneu.2018.06.243
- Three-dimensional angioarchitecture and microsurgical treatment of arteriovenous fistulas at the craniocervical junction.J Clin Neurosci. 2018; 53: 140-146https://doi.org/10.1016/j.jocn.2018.04.065
Firsching R, Kohl J, Skalej M, Beuing O: Resolution of Brainstem Edema after Neurosurgical Occlusion of Dural Arteriovenous Fistulas of the Craniocervical Junction: Report of Three Cases and Review; 2019.
- Surgical treatment of previously embolized craniocervical junction dural arteriovenous fistula.Neurosurg Focus FOC. 2019; 46: V2https://doi.org/10.3171/2019.2.FocusVid.18639
- Application of the selective indocyanine green videoangiography in microsurgical treatment of a craniocervical junction dural arteriovenous fistula.Neurosurg Focus FOC. 2019; 46: V5https://doi.org/10.3171/2019.2.FocusVid.18681
- Usefulness of preoperative cone beam computed tomography and intraoperative digital subtraction angiography for dural arteriovenous fistula at craniocervical junction: Technical case report.Surg Neurol Int. 2019; 10: 5https://doi.org/10.4103/sni.sni_439_17
- Efficacy of Intraarterial Fluorescence Video Angiography in Surgery for Dural and Perimedullary Arteriovenous Fistula at Craniocervical Junction.World Neurosurg. 2019; 126: e573-e579https://doi.org/10.1016/j.wneu.2019.02.097
- Surgical Management for Craniocervical Junction Arteriovenous Fistula Targeting the Intradural Feeder.World Neurosurg. 2020; 144: e685-e692https://doi.org/10.1016/j.wneu.2020.09.041
Patel K, Olijnyk LD, Tsang ACO, Pereira VM, Radovanovic I. Craniocervical Junction Vertebral Artery Dural Arteriovenous Fistula With Cranial and Spinal Venous Reflux: 2-Dimensional Operative Video; 2020.
Matsubara S, Toi H, Takai H, et al. Variations and management for patients with craniocervical junction arteriovenous fistulas: Comparison of dural, radicular, and epidural arteriovenous fistulas. Surg Neurol Int 2021;12:411-411. doi:10.25259/SNI_557_2021.
- Early rebleeding of a foramen magnum dural arteriovenous fistula: A case report and review of the literature.Radiol Case Rep. 2021; 16: 3499-3503https://doi.org/10.1016/j.radcr.2021.08.038
- Endovascular treatment of medullary bridging vein-draining dural arteriovenous fistulas: foramen magnum vs. craniocervical junction lesions.Neuroradiology. 2022; 64: 333https://doi.org/10.1007/s00234-021-02790-z
- Far Lateral Approach for Disconnection of Craniocervical Junction Dural Arteriovenous Fistula Presented with Myelopathy and Hydrocephalus.J Neurol Surg B Skull Base. 2021; 82: S45-S47https://doi.org/10.1055/s-0040-1714402
- Usefulness of arterial spin labeling in the evaluation for dural arteriovenous fistula of the craniocervical junction.Radiol Case Rep. 2021; 16: 1655-1659https://doi.org/10.1016/j.radcr.2021.04.006
- Progressive Myelopathy From a Craniocervical Junction Dural Arteriovenous Fistula.Stroke. 2021; 52: e278-e281https://doi.org/10.1161/STROKEAHA.120.032552
- Far Lateral Craniotomy for Obliteration of High-Risk Craniocervical Junction Arteriovenous Fistula.Neurol India. 2021; 69: 1554-1556https://doi.org/10.4103/0028-3886.333526
Gadot R Auid- Orcid: --- Fau - Gopakumar S, Gopakumar S Auid- Orcid: --- Fau - Wagner K, Wagner K Auid- Orcid: --- Fau - Xu DS, et al.: Foramen Magnum Dural Arteriovenous Fistula Presenting With Thoracic Myelopathy: Technical Case Report With 2-Dimensional Operative Video. 2021.
- Clinical heterogeneity of low flow spinal arteriovenous fistulas; a case series.BMC Neurol. 2021; 21: 366https://doi.org/10.1186/s12883-021-02394-3