Posterior cervical spinal cord infarction complicating the treatment of an intracranial dural arteriovenous fistula embolization

Case report

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✓ Acute ischemic infarction of the posterolateral bulbomedullary junction occurred in a 28-year-old man who underwent arterial embolization for the treatment of an intracranial dural arteriovenous malformation. The migration of the embolic agent in the posterior spinal artery via a peripheral anastomosis between the middle meningeal artery and the posterior meningeal artery was responsible for this complication. The cast of glue in the radiculopial system at the upper cervical level was visible on computed tomography scanning, and magnetic resonance imaging demonstrated circumscribed signal changes and restricted diffusion in the arterial territory of the bulbomedullary junction. The authors discuss the anatomical, clinical, and technical issues of this rare complication.

Abbreviations used in this paper:AVF = arteriovenous fistula; CT = computed tomography; DAVF = dural AVF; DS = digital subtraction; MMA = middle meningeal artery; MR = magnetic resonance; PICA = posterior inferior cerebellar artery; PMA = posterior meningeal artery; PSA = posterior spinal artery; VA = vertebral artery.
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Contributor Notes

Address reprint requests to:Raphaël Blanc, M.D., Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital Henri Mondor, 51, avenue du Maréchal De Lattre de Tassigny, 94010 Créteil Cedex, France. email: raphael.blanc@hmn.aphp.fr.

© AANS, except where prohibited by US copyright law.

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