Enhanced cervical MRI in identifying intracranial dural arteriovenous fistulae with spinal perimedullary venous drainage

C. J. Chen, C. M. Chen, T. K. Lin

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Diagnosis of an intracranial dural arteriovenous fistula (DAVF) with spinal perimedullary venous drainage is challenging because the presenting symptoms are usually related to dysfunction of the spine, not of the brain. Repeated spinal angiograms are usually performed before the diagnosis is finally made by cerebral angiography. We report two cases of intracranial DAVFs with spinal perimedullary venous drainage. In both cases contrast-enhanced cervical MRI demonstrated dilated lower brainstem and upper spinal veins, which, we believe, is a good indicator of the existence of such drainage. We suggest that, in cases with perimedullary serpentine enhancement on thoracic or lumbar MR images, additional Gd-enhanced cervical spinal MR imaging should be performed. The simple process of tracing the veins upwards may avoid a lot of unnecessary examinations and delay in the diagnosis.

Original languageEnglish
Pages (from-to)393-397
Number of pages5
Issue number6
Publication statusPublished - 1998
Externally publishedYes



  • Arteriovenous fistula
  • Brain diseases
  • Magnetic resonance imaging
  • Myelopathy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Radiological and Ultrasound Technology

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