A CERVICAL DURAL ARTERIOVENOUS-FISTULA IN A PATIENT PRESENTING WITH RADICULOPATHY - CASE-REPORT

A 51-year-old man presenting with radiculopathy with a rare cervical d ural arteriovenous fistula (AVF) is reported. Angiography revealed tha t the cervical dural AVF was fed mainly by the left C-3 and C-4 radicu lar arteries and drained into the internal vertebral venous plexus wit h no communication with intradural structures. The dural AVF was treat ed surgically after embolization therapy. Although the AVF showed mass effect on computerized tomography (CT) scanning, abnormal vessels, wh ich were suspected to drain the AVF, were observed intraoperatively to compress the left C-4 and C-5 nerve root sleeves. After resection of these abnormal epidural vessels, monoparesis of the left proximal uppe r extremity was markedly improved. In this patient, dynamic CT scannin g was useful in the initial diagnosis, and the preoperative embolizati on therapy was very effective.