くも膜下出血で発症した頭蓋頚椎移行部の dural AVF の 1 例

概要

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A 46-year-old male was admitted to our hospital presenting with subarachnoid hemorrhage. A computed tomography revealed subarachnoid hemorrhage in the prepontine cistern. Vertebral angiography showed a dural arteriovenous fistula at the craniovertebral junction. This dural arteriovenous fistula had two meningeal arteries from both vertebral arteries and a vein drainging into the intracranial venous system. Clipping of the draining vein was performed using the transcondylar approach. Ten days after the operation, the feeding arteries were still alive, but 2 months after the operation, the dural arteriovenous fistula was shown by angiography to have been eliminated completely. Dural arteriovenous fistula at the craniovertebral junction presenting with subarachnoid hemorrhage is a very rare entitiy. We discussed the clinical features, diagnostic problems, therapeutic strategies, and operative approach of our case and the previously reported 11 cases of dural arteriovenous fisutla at the craniovertebral junction in the literature.
2001-07-31