Case Reports
Tentorial Dural Arteriovenous Fistula Presenting with Myelopathy Successfully Treated by Transarterial Embolization with N-butyl-2-cyanoacrylate: A Case Report
2022 Volume 7 Issue 2 Pages 84-89
Details
2022 Volume 7 Issue 2 Pages 84-89
Objective: We report a case of myelopathy caused by a tentorial dural arteriovenous fistula (dAVF) that was effectively treated by transarterial embolization (TAE) with n-butyl-2-cyanoacrylate (NBCA).
Case Presentation: A 65-year-old man presented with gradually worsening paraparesis. The medulla oblongata and the cervical spinal cord were revealed as high-intensity areas on T2-weighted MRI, indicating intraaxial edema. Cerebral angiography revealed that the tentorial dAVF was supplied by multiple arteries, the right middle meningeal artery (MMA) and the tentorial artery, and drained via the petrosal vein into the spinal medullary veins. The AVF was treated by TAE with 12.5% NBCA via the MMA petrosquamous branch under flow control of the MHT with a balloon catheter. The residual shunt was still present following TAE; however, complete occlusion was confirmed on cerebral angiography 21 days later. Three months following the embolization, the symptoms were fully resolved.
Conclusion: TAE with NBCA for tentorial dAVF presenting with myelopathy can be a viable effective treatment, taking care to avoid cranial nerve palsy.
