TRANSCONDYLAR APPROACH FOR DURAL ARTERIOVENOUS-FISTULAS OF THE CERVICOMEDULLARY JUNCTION

BACKGROUND Spinal dural arteriovenous fistulas are abnormal arterioven ous connections on the surface of the dura. The site of the fistula is most commonly in the thoracic and lumbosacral regions and they are ra rely located in the cervical region. CASES The patients had two asympt omatic dural arteriovenous fistulas of the cervicomedullary junction f ed by the left posterior meningeal artery and draining to the dilated coronal venous plexus and the radiculomedullary vein. RESULTS The lesi ons were successfully treated by surgical interruption of the intrathe cal vein with coagulation via a suboccipital transcondylar approach an d a condylar fossa approach. Both patients left the hospital without s ignificant deficits. CONCLUSIONS We recommend that dural arteriovenous fistulas in the cervical region be surgically treated. (C) 1997 by El sevier Science Inc.