Pp. Versari et al., PROGRESSIVE MYELOPATHY CAUSED BY INTRACRANIAL DURAL ARTERIOVENOUS-FISTULA - REPORT OF 2 CASES AND REVIEW OF THE LITERATURE, Neurosurgery, 33(5), 1993, pp. 914-919
WE REPORT TWO rare cases of progressive myelopathy caused by intracran
ial dural arteriovenous fistulae with venous drainage into the spinal
medullary veins. Both patients were referred to us with a history of p
rogressively worsening quadriparesis. A posterior fossa dural arteriov
enous fistula with spinal venous drainage was discovered by angiograph
y in both cases. Treatment consisted of direct clipping of the venous
drainage in one patient and of transarterial embolization and excision
of the involved dural sinus in the other patient. Such procedures pro
vided a radioanatomical cure and marked neurological recovery in both
patients. Only 10 cases of progressive myelopathy caused by an intracr
anial dural arteriovenous fistula have been previously reported. Dysfu
nction of the cervical cord by venous engorgement is thought to be the
most probable cause of the neurological symptoms in such cases.