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KMID : 0361420110350050733
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Journal of Korean Academy of Rehabilitation Medicine
2011 Volume.35 No. 5 p.733 ~ p.737
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Dural Arteriovenous Fistula on the Brain Stem and Upper Cervical Spinal Cord - A Case Report -
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Sun Hyung-Suk
Yun Hyun-Sik
Song Min-Keun
Han Jae-Young
Choi In-Sung
Lee Sam-Gyu
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Abstract
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A 53-year-old man abruptly developed headache and unconsciousness. Brain computed tomography (CT) and CT angiography showed subarachnoid hemorrhage, intraventricular hemorrhage, and multiple tortuous vascular structures on the brain stem and upper cervical spinal cord. Four-vessel angiography displayed intradural ventral arteriovenous fistula, supplied by the left vertebral and occipital arteries. Drainage was via both sigmoid sinus and cervical venous plexus. He had been treated with transarterial coil embolization of the left vertebral artery. Subsequently, he suff ered from left hemiplegia and cognitive problem. Brain magnetic resonance (MR) and MR angiography performed 4 weeks later revealed multiple infarctions on the left cerebellum, left upper cervical spinal cord, and both medial thalamus, as well as occlusion of the left vertebral artery with reduction in varix size. After rehabilitative management, his muscle strength and cognitive function improved. We report a very rare case of dural arteriovenous fi stula on the brain stem and upper cervical spinal cord.
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KEYWORD
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Arteriovenous fi stula, Brain stem, Spinal cord
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