2021 Volume 12 Issue 1.2 Pages 32-37
Introduction: Development of Dural Arteriovenous Fistula (AVF) in the craniocervical junction (CCJ) is rare. CCJ dural AVF often presents as an intracranial lesion, and spinal cord symptoms are relatively rare.
Case Report: An 81-year-old man was diagnosed with ossification of the posterior longitudinal ligament and was referred to our hospital with the chief complaints of lower limb muscle weakness and dyspnea. Because he had received an implantable cardioverter defibrillator for hypertrophic cardiomyopathy, magnetic resonance imaging was contraindicated. His deep tendon reflexes had decreased in the upper extremities and increased in the lower extremities. His manual muscle testing score for the upper and lower extremities was decreased to 1-3, and the left face, trunk, and upper lower limbs showed impaired thermal nociception. Computed tomography (CT) myelography revealed slight compression of the spinal cord by ossification of the posterior longitudinal ligament of the spine at C2-C7 level. Contrast-enhanced CT revealed an abnormally enlarged vein at the craniovertebral junction. He was diagnosed with CCJ dural AVF and underwent surgical treatment.
Conclusions: We report a case of CCJ dural AVF with spinal cord symptoms and dyspnea. A vascular lesion, including dural AVF, should be considered if a patient presents spinal cord symptoms without compressive spinal disease.
