Journal of neurological surgery. Part A, Central European neurosurgery · 2022
Acquired Chiari Type I Malformation Associated with Type IV Dural Arteriovenous Fistula: Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Luy Diego D, Agarwal Nitin, McDowell Michael M, Tonetti Daniel A, Goldschmidt Ezequiel, Friedlander Robert M
Аннотация
BACKGROUND: Chiari malformations, usually congenital, can rarely be associated with arteriovenous (AV) fistulas. We present the first case involving a type IV dural AV fistula with a Chiari type I malformation.
METHODS: Retrospective chart review was performed to obtain pertinent details regarding history and examination, pathologic findings, and treatment course.
RESULTS: A 63-year-old woman with a 2-year history of migraines presented with 5 months of occipital, right-sided headaches and neck pain exacerbated by Valsalva maneuvers. Computed tomography (CT) and magnetic resonance imaging (MRI) of the head showed a possible right occipital AV malformation, bilateral cerebellar subdural hygromas, and tonsillar crowding at the foramen magnum indicating an acquired Chiari type I malformation. Angiography demonstrated a Cognardtype IV right posterior occipital dural AV fistula supplied by bilateral middle meningeal and posterior meningeal arteries.
CONCLUSION: After treatment of the dural AV fistula, hygroma evacuation, and decompression of the acquired Chiari malformation, the patient's Valsalva-induced headaches abated.
METHODS: Retrospective chart review was performed to obtain pertinent details regarding history and examination, pathologic findings, and treatment course.
RESULTS: A 63-year-old woman with a 2-year history of migraines presented with 5 months of occipital, right-sided headaches and neck pain exacerbated by Valsalva maneuvers. Computed tomography (CT) and magnetic resonance imaging (MRI) of the head showed a possible right occipital AV malformation, bilateral cerebellar subdural hygromas, and tonsillar crowding at the foramen magnum indicating an acquired Chiari type I malformation. Angiography demonstrated a Cognardtype IV right posterior occipital dural AV fistula supplied by bilateral middle meningeal and posterior meningeal arteries.
CONCLUSION: After treatment of the dural AV fistula, hygroma evacuation, and decompression of the acquired Chiari malformation, the patient's Valsalva-induced headaches abated.