Transarterial embolization of a cervical dural arteriovenous fistula. Presenting with subarachnoid hemorrhage

Sameer A. Ansari*, J. P. Lassig, E. Nicol, B. G. Thompson, J. J. Gemmete, D. Gandhi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

We describe a case of a 75-year-old man who presented with acute onset of headache and subarachnoid hemorrhage and initial cerebral angiography was deemed "negative". In retrospect, a faint contrast collection was present adjacent to the right vertebral artery at the C1 level suspicious for a small dural arteriovenous fistula (dAVF). Follow-up angiography with selective microcatheter injections of the right vertebral artery and C1 radicular artery confirmed a complex dAVF with characteristically specific venous drainage patterns associated with a subarachnoid hemorrhage presentation. Subsequently, the cervical dAVF was treated with superselective glue ernbolization resulting in complete occlusion. Cervical dAVFs are extremely rare vascular causes of subarachnoid hemorrhage. Both diagnostic angiography and endovascular treatment of these lesions can be challenging, especially in an emergent setting, requiring selective evaluation of bilateral vertebral arteries and careful attention to their cervical segments. Although only a single prior case ora cervical dAVF presenting with subarachnoid hemorrhage has been successfully treated with embolization, modern selective transarterial techniques may allow easier detection and treatment of subtle pathologic arteriovenous connections.

Original languageEnglish (US)
Pages (from-to)313-318
Number of pages6
JournalInterventional Neuroradiology
Volume12
Issue number4
StatePublished - Dec 2006

Keywords

  • Cervical spine
  • Craniocervical junction
  • Dural arteriovenous fistula
  • Embolization
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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