Dural arteriovenous fistulas represent approximately 10% of all intracranial vascular malformations, of which 1 to 2% are located at the craniocervical junction. Their location at the craniocervical junction is uncommon but potentially significant, given its proximity to and relationship with vital anatomical structures in this region. The association of a dural arteriovenous fistula with a venous aneurysm is rare. In this report, we present the case of a 49-year-old patient with no particular pathological history who was admitted for acute headaches. The neurological examination revealed a patient with grade I WFNS, intracranial hypertension syndrome. Radiological investigations including CT, CT angio and MRI revealed a fisher IV subarachnoid hemorrhage due to a ruptured venous aneurysm associated to an arteriovenous fistula at the craniocervical junction. He underwent clipping of the veinous aneurysm and microsurgical obliteration of the fistula. The postoperative course was uneventful. The clinical examination at 1-year post-op was unremarkable, and the follow-up MRI at 1-year post-op showed complete obliteration of the malformation. This report showed ruptured dural arteriovenous fistula should be considered in the etiology workup for posterior fossa subarachnoid hemorrhage. Effective and safe obliteration is possible without angiography.
| Published in | International Journal of Neurosurgery (Volume 8, Issue 2) |
| DOI | 10.11648/j.ijn.20240802.15 |
| Page(s) | 45-49 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Subarachnoid Hemorrhage, Craniocervical Junction, Dural Arteriovenous Fistula, Venous Aneurysm, Microsurgical Obliteration
| [1] | Alkhaibary, A., Alnefaie, N., Alharbi, A. et al. Intracranial dural arteriovenous fistula: a comprehensive review of the history, management, and future prospective. Acta Neurol Belg 123, 359–366 (2023). |
| [2] | Baharvahdat H, Ooi YC, Kim WJ, Mowla A, Coon AL, Colby GP. Updates in the management of cranial dural arteriovenous fistula. Stroke Vasc Neurol. 2019 Nov 21; 5(1): 50-58. |
| [3] | Salem MM, Srinivasan VM, Tonetti DA, Ravindran K, Taussky P, Yang K, Karahalios K, Raygor KP, Naylor RM, Catapano JS, Tavakoli-Sabour S, Abdelsalam A, Chen SH, Grandhi R, Jankowitz BT, Baskaya MK, Mascitelli JR, Van Gompel JJ, Cherian J, Couldwell WT, Kim LJ, Cohen-Gadol AA, Starke RM, Kan P, Dehdashti AR, Abla AA, Lawton MT, Burkhardt JK. Microsurgical Obliteration of Craniocervical Junction Dural Arteriovenous Fistulas: Multicenter Experience. Neurosurgery. 2023 Jan 1; 92(1): 205-212. |
| [4] | Onu DO, Hunn AW, Harle RA. A rare association of cerebral dural arteriovenous fistula with venous aneurysm and contralateral flow-related middle cerebral artery aneurysm. BMJ Case Rep. 2013 Sep 19; 2013: bcr2013200764. |
| [5] | Hashiguchi A, Mimata C, Ichimura H, et al. Venous aneurysm development associated with a dural arteriovenous fistula of the anterior cranial fossa with devastating hemorrhage-case report. Neurol Med Chir 2007; 47: 70–3. |
| [6] | Zhao J, Xu F, Ren J, Manjila S, Bambakidis NC. Dural arteriovenous fistulas at the craniocervical junction: a systematic review. J Neurointerv Surg. 2016 Jun; 8(6): 648-53. |
| [7] | Lee SK, Hetts SW, Halbach V et al (2017) Standard and guidelines: intracranial dural arteriovenous shunts. J Neurointerv Surg 9: 516–523. |
| [8] | Narayanan S, Cawley CM. Treatment of other intracranial dural arteriovenous fistulas. In: Winn HR, Berger MS, eds. Youmans Neurol Surg. 6th edn Philadelphia: Elsevier Saunders, 2011: 4107–13. |
| [9] | Cognard C, Gobin YP, Pierot L, et al. Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Radiology 1995; 2013: 671–80 |
| [10] | Ansari SA, Lassig JP, Nicol E, et al. Transarterial embolization of a cervical dural arteriovenous fistula presenting with subarachnoid hemorrhage. Interv Neuroradiol 2006; 12: 313–18. |
| [11] | Chen G, Wang Q, Tian Y, et al. Dural arteriovenous fistulae at the craniocervical junction: the relation between clinical symptom and pattern of venous drainage. Acta Neurochir Suppl 2011; 112(Pt2): 99–104. |
| [12] | Kulwin C, Bohnstedt BN, Scott J, et al. Dural arteriovenous fistulas presenting with brainstem dysfunction: diagnosis and surgical treatment. Neurosurg Focus 2012; 32(5): E10. |
| [13] | Wu Q, Wang HD, Shin YS, et al. Brainstem congestion due to dural arteriovenous fistula at the craniocervical junction. J Korean Neurosurg Soc 2014; 55: 152–5. |
| [14] | Aviv RI, Shad A, Tomlinson G, et al. Cervical dural arteriovenous fistulae manifesting as subarachnoid hemorrhage: report of two cases and literature review. AJNR Am J Neuroradiol 2004; 25: 854–8. |
| [15] | Kai Y, Hamada J, Morioka M, et al. Arteriovenous fistulas at the cervicomedullary junction presenting with subarachnoid hemorrhage: six case reports with special reference to the angiographic pattern of venous drainage. AJNR Am J Neuroradiol 2005; 26: 1949–54. |
| [16] | Chaichana KL, Coon AL, Tamargo RJ, et al. Dural arteriovenous fistulas: epidemiology and clinical presentation. Neurosurg Clin N Am 2012; 2013: 7–13 |
| [17] | Sato K, Shimizu T, Fukuhara T, et al. Ruptured anterior communicating artery aneurysm associated with anterior cranial fossa dural arteriovenous fistula—case report. Neurol Med Chir 2011; 51: 40-4. |
APA Style
Thioub, M., Atakla, H. G., Mbaye, M., Wague, D., Djigo, R. S., et al. (2024). Subarachnoid Hemorrhage Revealing a Fistula Point Venous Aneurysm in a Dural Arteriovenous Fistula at the Craniocervical Junction: A Case Report. International Journal of Neurosurgery, 8(2), 45-49. https://doi.org/10.11648/j.ijn.20240802.15
ACS Style
Thioub, M.; Atakla, H. G.; Mbaye, M.; Wague, D.; Djigo, R. S., et al. Subarachnoid Hemorrhage Revealing a Fistula Point Venous Aneurysm in a Dural Arteriovenous Fistula at the Craniocervical Junction: A Case Report. Int. J. Neurosurg. 2024, 8(2), 45-49. doi: 10.11648/j.ijn.20240802.15
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ijn.20240802.15,
author = {Mbaye Thioub and Hugues Ghislain Atakla and Maguette Mbaye and Daouda Wague and Richard Salif Djigo and Coumba Camara and El H Cheikh Ndiaye Sy and Mamadou Diawo Bah and Moustapha Diallo and Alioune Badara Thiam and Momar Codé Ba},
title = {Subarachnoid Hemorrhage Revealing a Fistula Point Venous Aneurysm in a Dural Arteriovenous Fistula at the Craniocervical Junction: A Case Report
},
journal = {International Journal of Neurosurgery},
volume = {8},
number = {2},
pages = {45-49},
doi = {10.11648/j.ijn.20240802.15},
url = {https://doi.org/10.11648/j.ijn.20240802.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20240802.15},
abstract = {Dural arteriovenous fistulas represent approximately 10% of all intracranial vascular malformations, of which 1 to 2% are located at the craniocervical junction. Their location at the craniocervical junction is uncommon but potentially significant, given its proximity to and relationship with vital anatomical structures in this region. The association of a dural arteriovenous fistula with a venous aneurysm is rare. In this report, we present the case of a 49-year-old patient with no particular pathological history who was admitted for acute headaches. The neurological examination revealed a patient with grade I WFNS, intracranial hypertension syndrome. Radiological investigations including CT, CT angio and MRI revealed a fisher IV subarachnoid hemorrhage due to a ruptured venous aneurysm associated to an arteriovenous fistula at the craniocervical junction. He underwent clipping of the veinous aneurysm and microsurgical obliteration of the fistula. The postoperative course was uneventful. The clinical examination at 1-year post-op was unremarkable, and the follow-up MRI at 1-year post-op showed complete obliteration of the malformation. This report showed ruptured dural arteriovenous fistula should be considered in the etiology workup for posterior fossa subarachnoid hemorrhage. Effective and safe obliteration is possible without angiography.
},
year = {2024}
}
TY - JOUR T1 - Subarachnoid Hemorrhage Revealing a Fistula Point Venous Aneurysm in a Dural Arteriovenous Fistula at the Craniocervical Junction: A Case Report AU - Mbaye Thioub AU - Hugues Ghislain Atakla AU - Maguette Mbaye AU - Daouda Wague AU - Richard Salif Djigo AU - Coumba Camara AU - El H Cheikh Ndiaye Sy AU - Mamadou Diawo Bah AU - Moustapha Diallo AU - Alioune Badara Thiam AU - Momar Codé Ba Y1 - 2024/12/31 PY - 2024 N1 - https://doi.org/10.11648/j.ijn.20240802.15 DO - 10.11648/j.ijn.20240802.15 T2 - International Journal of Neurosurgery JF - International Journal of Neurosurgery JO - International Journal of Neurosurgery SP - 45 EP - 49 PB - Science Publishing Group SN - 2640-1959 UR - https://doi.org/10.11648/j.ijn.20240802.15 AB - Dural arteriovenous fistulas represent approximately 10% of all intracranial vascular malformations, of which 1 to 2% are located at the craniocervical junction. Their location at the craniocervical junction is uncommon but potentially significant, given its proximity to and relationship with vital anatomical structures in this region. The association of a dural arteriovenous fistula with a venous aneurysm is rare. In this report, we present the case of a 49-year-old patient with no particular pathological history who was admitted for acute headaches. The neurological examination revealed a patient with grade I WFNS, intracranial hypertension syndrome. Radiological investigations including CT, CT angio and MRI revealed a fisher IV subarachnoid hemorrhage due to a ruptured venous aneurysm associated to an arteriovenous fistula at the craniocervical junction. He underwent clipping of the veinous aneurysm and microsurgical obliteration of the fistula. The postoperative course was uneventful. The clinical examination at 1-year post-op was unremarkable, and the follow-up MRI at 1-year post-op showed complete obliteration of the malformation. This report showed ruptured dural arteriovenous fistula should be considered in the etiology workup for posterior fossa subarachnoid hemorrhage. Effective and safe obliteration is possible without angiography. VL - 8 IS - 2 ER -
Department of Neurosurgery, Cheikh Anta Diop University, Dakar, Senegal
