ABSTRACT
Currently, various posterior surgical techniques are available for cervical spondylotic myelopathy. These techniques include laminoplasty and laminectomy with or without fusion, and are often used in patients with multilevel cervical stenosis. They were developed with the intent to reduce the risk of complications such as injury to the spinal cord and nerve roots, C5 palsy, postlaminectomy membrane, and postoperative kyphosis. Posterior decompression for cervical spondylotic myelopathy is effective in improving neurological function in patients with appropriate surgical indications.
Subject(s)
Spinal Cord Diseases , Spinal Fusion , Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/surgery , Decompression, Surgical , Humans , Laminectomy , Postoperative Complications , Spinal Cord Diseases/surgery , Treatment OutcomeABSTRACT
Dural arteriovenous fistulas occurring at the craniocervical junction(CCJd-AVF)are uncommon; however, they demonstrate a wide range of clinical presentations. We describe the case of a patient with pontine hemorrhage suspected due to CCJd-AVF. A 68-year-old man presented to our hospital with a sudden onset of left hemiparesis. Cranial computed tomography(CT)revealed pontine and subarachnoid hemorrhage. Magnetic resonance imaging, as well as MR, CT, and left vertebral angiograms were performed and showed a CCJd-AVF in addition to a varix coincident with the hematoma cavities. The patient was successfully treated using surgical drainer clipping. A CCJd-AVF presenting concomitantly with a pontine hemorrhage is extremely rare. Careful assessment of the anatomical relationship between the skull base and the surrounding vascular structures is important to plan neurosurgical procedures for direct interruption of the draining vein. Three-dimensional CT angiography is a useful modality that facilitates visualization of complex and anomalous anatomical structures.