PROGRESSIVE MYELOPATHY CAUSED BY INTRACRANIAL DURAL ARTERIOVENOUS-FISTULA - REPORT OF 2 CASES AND REVIEW OF THE LITERATURE

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.