A Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction in Whom Endovascular Treatment Was Initially Performed, Followed by Surgical Management

• Published in: Journal of Neuroendovascular Therapy Vol. 12; no. 5; pp. 241 - 246
• Main Authors: Kaneko, Junya, Shibata, Ami, Kitahashi, Akiko, Kudo, Saori, Unemoto, Kyoko, Yamaguchi, Hidenori, Yamazaki, Michio, Tamaki, Tomonori, Matsumoto, Gaku, Yokota, Hiroyuki, Hyodo, Akio
• Format: Journal Article
• Language: English
• Published: The Japanese Society for Neuroendovascular Therapy 2018
• Subjects: craniocervical junction; craniotomy; dural arteriovenous fistula; endovascular treatment; subarachnoid hemorrhage
• ISSN: 1882-4072; 2186-2494
• DOI: 10.5797/jnet.cr.2017-0011

Objective: Dural arteriovenous fistulae at craniocervical junction (CCJ dAVF) cause subarachnoid hemorrhage (SAH). We present a case of CCJ dAVF with SAH in which endovascular treatment was initially performed, followed by surgical management, leading to radical cure.Case Presentation: Transarterial embolization was initially performed because of unfavorable clinical condition of the patient, resulted in main feeder occlusion. As this made the shunting point clearer, surgical drainer occlusion consequently facilitated, and radical cure could be achieved.Conclusion: To treat CCJ dAVF, endovascular treatment and surgical management were performed. The former alone did not result in radical cure, but decreased the shunt volume, facilitating the assessment of vascular anatomy.