Foramen magnum dural arteriovenous fistula (FM-DAVF) is a subset of craniocervical junction arteriovenous fistulas. We report a rare case of FM-DAVF with early rebleeding and review the literature. A 50-year-old man experienced 3 episodes of intracranial bleeding from a vessel malformation in the acute stage. We identified an FM-DAVF, supplied by multiple feeding arteries (eg, left ascending pharyngeal artery) that drained into the straight sinus and left superior petrosal sinus. The draining vein had venous varices. We performed transarterial feeder embolization and surgical disconnection of the DAVF. Early rebleeding of FM-DAVF is rare. High-risk patients require risk assessment and appropriate treatment as soon as possible in the acute stage.
Keywords: AVM, arteriovenous malformation; Ascending pharyngeal artery; CT, computed tomography; Craniocervical junction arteriovenous fistula; DAVF, dural arteriovenous fistula; DSA, digital subtraction angiography; Early rebleeding; Foramen magnum dural arteriovenous fistula; GKS, gamma knife surgery; ICG, indocyanine green; MRI, magnetic resonance imaging; PICA, posterior inferior cerebellar artery; SAH, subarachnoid hemorrhage.
© 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington.