Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
World Neurosurg. 2020 May;137:55-61. doi: 10.1016/j.wneu.2020.01.122. Epub 2020 Jan 27.
The artery of Wollschlaeger and Wollschlaeger is a tentorial branch of the superior cerebellar artery that is usually not visualized on conventional cerebral angiography, unless it is pathologically enlarged. It can be recruited as part of the blood supply to tentorial dural arteriovenous fistulas (AVFs), although this occurs infrequently.
Here we report the clinico-radiologic evaluation and treatment of a 48-year-old man referred to our institution for hitherto workup negative progressive, relapsing quadriparesis. This represents the first reported case of cervical myelopathy caused by venous congestion from a type V dural AVF supplied by the artery of Wollschlaeger and Wollschlaeger.
The anatomic discrepancy between the symptomatic spinal cord lesion and the etiologic intracranial fistula frequently results in delayed care in cases of myelopathy due to intracranial dural AVFs. Familiarity with these disorders and of their pathophysiologic mechanisms is important to avoid unnecessary diagnostic delays.
Wollschlaeger 和 Wollschlaeger 动脉是小脑上动脉的幕支，通常不会在常规脑血管造影中显影，除非它病理性增大。它可以作为天幕硬脑膜动静脉瘘（AVF）供血的一部分被募集，尽管这种情况很少发生。
我们在此报告一例 48 岁男性的临床-放射学评估和治疗情况，该患者因进行性、复发性四肢瘫痪而被转诊至我院，此前检查均为阴性。这是首例由 Wollschlaeger 和 Wollschlaeger 动脉供血的 V 型硬脑膜 AVF 引起的颈髓病的报道。
由于脊髓病变和颅内瘘之间的解剖差异，导致由颅内硬脑膜 AVF 引起的脊髓病的治疗常常被延迟。熟悉这些疾病及其病理生理机制对于避免不必要的诊断延误非常重要。
