TY - JOUR
T1 - Acquired Chiari Type i Malformation Associated with Type IV Dural Arteriovenous Fistula
T2 - Case Report
AU - Luy, Diego D.
AU - Agarwal, Nitin
AU - McDowell, Michael M.
AU - Tonetti, Daniel A.
AU - Goldschmidt, Ezequiel
AU - Friedlander, Robert M.
N1 - Publisher Copyright:
© 2021 Georg Thieme Verlag. All rights reserved.
PY - 2021/6/5
Y1 - 2021/6/5
N2 - 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.
AB - 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.
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U2 - 10.1055/a-1792-5000
DO - 10.1055/a-1792-5000
M3 - Article
C2 - 35263802
AN - SCOPUS:85134074116
SN - 2193-6315
VL - 85
SP - 94
EP - 99
JO - Journal of Neurological Surgery, Part A: Central European Neurosurgery
JF - Journal of Neurological Surgery, Part A: Central European Neurosurgery
IS - 1
ER -