A Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction in Whom Endovascular Treatment Was Initially Performed, Followed by Surgical Management

Junya Kaneko; Ami Shibata; Akiko Kitahashi; Saori Kudo; Kyoko Unemoto; Hidenori Yamaguchi; Michio Yamazaki; Tomonori Tamaki; Gaku Matsumoto; Hiroyuki Yokota; Akio Hyodo

doi:10.5797/jnet.cr.2017-0011

Case Reports

A Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction in Whom Endovascular Treatment Was Initially Performed, Followed by Surgical Management

Junya Kaneko, Ami Shibata, Akiko Kitahashi, Saori Kudo, Kyoko Unemoto, Hidenori Yamaguchi, Michio Yamazaki, Tomonori Tamaki, Gaku Matsumoto, Hiroyuki Yokota, Akio Hyodo

Author information

Junya Kaneko
Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
Ami Shibata
Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
Akiko Kitahashi
Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
Saori Kudo
Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
Kyoko Unemoto
Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
Hidenori Yamaguchi
Department of Radiology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
Michio Yamazaki
Department of Neurosurgery, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
Tomonori Tamaki
Department of Neurosurgery, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
Gaku Matsumoto
Department of Emergency and Critical Care Center, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan
Hiroyuki Yokota
Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
Akio Hyodo
Department of Neurosurgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan

Keywords: craniocervical junction, dural arteriovenous fistula, subarachnoid hemorrhage, endovascular treatment, craniotomy

JOURNAL OPEN ACCESS

2018 Volume 12 Issue 5 Pages 241-246

DOI https://doi.org/10.5797/jnet.cr.2017-0011

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Details

Abstract

Objective: Dural arteriovenous fistulae at craniocervical junction (CCJ dAVF) cause subarachnoid hemorrhage (SAH). We present a case of CCJ dAVF with SAH in which endovascular treatment was initially performed, followed by surgical management, leading to radical cure.

Case Presentation: Transarterial embolization was initially performed because of unfavorable clinical condition of the patient, resulted in main feeder occlusion. As this made the shunting point clearer, surgical drainer occlusion consequently facilitated, and radical cure could be achieved.

Conclusion: To treat CCJ dAVF, endovascular treatment and surgical management were performed. The former alone did not result in radical cure, but decreased the shunt volume, facilitating the assessment of vascular anatomy.

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