Reversible tonsillar prolapse and syringomyelia after embolization of a tectal arteriovenous malformation

Case report and review of the literature

Georges Rodesch M.D., Ph.D., Bernard Otto M.D., Micheline Mouchamps M.D. and Jacques Born M.D., Ph.D.
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✓ The authors report the case of a 21-year-old woman who presented with headaches, frequent sensations of loss of equilibrium, and intermittent strabismus. A tectal arteriovenous malformation (AVM) was diagnosed based on magnetic resonance (MR) imaging findings. The AVM drained toward the straight sinus and was associated with a tonsillar prolapse (Chiari malformation Type I [CM-I]) and cervical syringomyelia. The tectal AVM was embolized with N-butyl cyanoacrylate, and disconnection of about 80% of the lesion was obtained. All clinical symptoms resolved after embolization, and radiosurgery was proposed to treat the malformation remnant. A control MR image confirmed the regression of the tonsillar prolapse and the disappearance of the syrinx. This report emphasizes that CM-I and syringomyelia may be acquired and related to hydrovenous disorders.

Abbreviations used in this paper: AVM = arteriovenous malformation; CM-I = Chiari malformation Type I; CSF = cerebrospinal fluid; MR = magnetic resonance.

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Contributor Notes

Address reprint requests to: Georges Rodesch, M.D., Ph.D., Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital Foch, 40 rue Worth, 92150 Suresnes, France. email: g.rodesch@hopital-foch.org.
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