A case of isolated sigmoid sinus dural arteriorvenous fistula showing high intensity areas on T2 weighted image in the brain stem, cerebellum, and cervical spinal cord

• Published in: Journal of Neuroendovascular Therapy 2008, Vol.2(3), pp.217-221
• Main Authors: OHSHIMA, Kousuke, TERADA, Tomoaki, OOKUBO, Shinji, HIYAMA, Takami, KOBAYASHI, Hiroo, KUDOU, Tadashi, ENDOH, Shinichi, HASHIMOTO, Takuo
• Format: Article
• Language: English
• Subjects: dural arteriorvenous fistula; transvenous embolization; venous drainage; venous hypertension
• ISSN: 1882-4072; 2186-2494
• DOI: 10.5797/jnet.2.217

Objective: A rare case of dural arteriovenous fistula (dAVF), which demonstrated high intensity areas in the brain stem, cervical spinal cord, and cerebellum on T2-weighted magnetic resonance imaging, was presented. Its mechanism was discussed in this paper. Clinical presentation: A 74-year-old female was admitted due to severe dizziness and cerebellar ataxia. Cerebral angiography showed an isolated sigmoid sinus dAVF fed by the ascending pharyngeal, occipital, and tentorial arteries, and draining from the left petrosal vein to the confluence, contralateral superior petrosal sinus, and to the anterior and posterior spinal veins, via the veins around the brain stem and the numerous cerebellar cortical veins. Intervention: Transvenous embolization was performed using detachable coils through the microcatheter, which was navigated through the occluded left transverse sinus via the transfemoral route. Symptoms improved markedly after endovascular treatment. Conclusion: In this case, venous hypertension in the brain stem, cerebellum and cervical spinal cord, caused MRI abnormalities. With these MRI findings, dAVF should be included in the differential diagnoses.