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KMID : 1155820100050010053
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Neurointervention
2010 Volume.5 No. 1 p.53 ~ p.57
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Dural Arteriovenous Fistula at the Foramen Magnum with Holocord Myelopathy: Case Report
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Lee Jong-Young
Han Moon-Hee
Kwon Bae-Ju
Cho Young-Dae
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Abstract
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We report a case of dural arteriovenous fistula at the foramen magnum with a diagnostic delay of 10 months from initial myelopathic symptoms. A 59-year-old male with urinary incontinence and progressive ascending weakness of the extremities was transferred through two other hospitals to our institution with no tentative or established diagnosis. A correct diagnosis was not made until 10 months after initial symptoms: follow-up MR images revealed diffuse edema involving the holocord and lower brain stem, and engorged veins around the spinal cord. Cerebral angiography confirmed a dural arteriovenous fistula drained by perimedullary venous plexus. That fistula was occluded by transarterial embolization using NBCA (n-butyl cyanoacrylate). However, it seemed hard to expect any improvement in the clinical condition of the patient due to considerable diagnostic delay. To avoid missing a chance of treatment for this potentially reversible disease, early diagnosis is mandatory and it requires a high-level suspicion.
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KEYWORD
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Dural arteriovenous fistula, Foramen magnum, Perimedullary venous drainage, Myelopathy
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