Araki Yoshio, Bhuwana Putra Made, Tsukada Tetsuya, Niryana I Wayan, Saito Ryuta
Neurosurgery, Japanese Red Cross Aichi Medical Centre Nagoya Daini Hospital, Nagoya, JPN.
Neurosurgery, Udayana University, Denpasar, IDN.
Cureus. 2024 Jul 27;16(7):e65547. doi: 10.7759/cureus.65547. eCollection 2024 Jul.
Dural arteriovenous fistula (DAVF) of the craniocervical junction is exceptionally rare. The anatomy of the craniocervical junction area is very complex and is composed of the medulla and spinal cord along with intricate neurovascular structures. A thorough assessment of the angioarchitecture of the fistula is obligatory for choosing the most appropriate treatment for the patient. In this report, we describe the nuance of microsurgical obliteration of craniocervical junction DAVF utilizing intraoperative angiography. A 38-year-old male in a normal state of health was referred to our hospital for an abnormality in his brain checkup. Workup diagnostics showed a DAVF on the craniocervical junction area with feeders from ascending pharyngeal, vertebral, and occipital arteries, with the draining vein mainly to the basal vein of Rosenthal. Microsurgical obliteration of the main draining vein was done with the help of intraoperative digital subtraction angiography with a good outcome. Craniocervical DAVF is a rare entity. Meticulous evaluation of arterial and venous fistula points is necessary to decide the best treatment option for this case. Microsurgical obliteration is a feasible and more straightforward procedure for treating craniocervical DAVF.
颅颈交界区硬脑膜动静脉瘘（DAVF）极为罕见。颅颈交界区的解剖结构非常复杂，由延髓、脊髓以及错综复杂的神经血管结构组成。对瘘管的血管构筑进行全面评估对于为患者选择最合适的治疗方法至关重要。在本报告中，我们描述了利用术中血管造影对颅颈交界区DAVF进行显微手术闭塞的细微差别。一名38岁健康状态正常的男性因脑部检查异常被转诊至我院。检查诊断显示颅颈交界区存在DAVF，供血动脉来自咽升动脉、椎动脉和枕动脉，引流静脉主要汇入罗森塔尔基底静脉。在术中数字减影血管造影的辅助下对主要引流静脉进行了显微手术闭塞，效果良好。颅颈交界区DAVF是一种罕见疾病。细致评估动脉和静脉瘘点对于确定该病例的最佳治疗方案很有必要。显微手术闭塞是治疗颅颈交界区DAVF一种可行且更直接的方法。
