Autor(es): Mathon B, Gallas S, Tuillier T, Bekaert O, Decq P, Brugieres P, Nouet A, Gaston A

Resumo: Intracranial dural arteriovenous fistulae with perimedullary venous drainage are unusual type of vascular brain malformations. Patients may present with a rapidly progressive ascending myelopathy associated with autonomic dysfunction, which can cause a misdiagnosis and delay the therapeutic management. These clinical signs must be quickly recognized to avoid a poor outcome. The authors report the case of a 60-year-old woman presenting with a progressive myelopathy due to a dural arteriovenous fistula with perimedullary venous drainage. The diagnosis was suspected on brain-spinal MRI and confirmed by brain arteriography visualizing the arteriovenous shunt in the middle segment of the superior petrous sinus. MRI showed edema in the medulla oblongata. The treatment was performed early by endovascular glue embolization of the arteriovenous shunt and of the origin of the vein. Brain arteriography and clinical follow-up, one month later, showed complete disappearance of the dural fistula and regression of clinical symptoms. MRI control showed the reduction of the brain stem edema. Because of the early pejorative prognosis of these kinds of fistulae, early diagnosis and treatment are needed.

Palavras-Chave: Atypical spinal compression; Colle; Compression médullaire atypique; Diagnostic différentiel syndrome de Guillain-Barré; Differential diagnosis of Guillain-Barré syndrome; Drainage veineux périmédullaire; Dural arteriovenous fistulae; Embolisation; Fistule durale intracrânienne; Glue embolization; Perimedullary drainage; Type V

Imprenta: Neuro-Chirurgie, v. 59, n. 3, p. 133-137, 2013

Identificador do objeto digital: 10.1016/j.neuchi.2013.04.009 

Descritores: Guillain-Barre Syndrome - Cytopathology ; Guillain-Barre Syndrome - Clinical examination

Data de publicação: 2013

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