Transarterial Onyx embolization of jugular foramen dural arteriovenous fistula with spinal venous drainage manifesting as myelopathy-a case report and review of the literature

Interv Neuroradiol. 2016 Oct;22(5):579-83. doi: 10.1177/1591019916654431. Epub 2016 Jul 11.

Abstract

We report a rare case of jugular foramen dural arteriovenous fistula (DAVF) with spinal venous drainage. A 48-year-old woman suffered from progressive weakness of lower extremities and incontinence of urine and feces for 14 days. Magnetic resonance imaging (MRI) revealed a tortuous posterior medullary vein at C2-T2 and ischemic signal at C2-C4 of the spinal cord. Brain MRI revealed an abnormal high signal near the left jugular foramen. Digital subtraction angiography of the spinal vascular was negative, while brain angiography showed a left jugular foramen DAVF with spinal perimedullary venous drainage. The patient recovered completely soon after endovascular embolization with Onyx-18. Diagnosis of a DAVF presenting with myelopathy is challenging. Early diagnosis and treatment are essential for a favorable outcome.

Keywords: Dural arteriovenous fistula; Onyx; jugular foramen; myelopathy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Central Nervous System Vascular Malformations / diagnostic imaging*
  • Central Nervous System Vascular Malformations / therapy*
  • Diagnostic Imaging
  • Drug Combinations
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Middle Aged
  • Polyvinyls / therapeutic use*
  • Spinal Cord / blood supply*
  • Spinal Cord Diseases / diagnostic imaging*
  • Tantalum / therapeutic use*

Substances

  • Drug Combinations
  • Onyx 18
  • Polyvinyls
  • Tantalum