Anterior condylar vein dural AVF with intraosseous vascular nidus in the hypoglossal canal : a case report

  • KONDO Yayoi
    Department of Radiology, Nagatomi Neurosurgical Hospital
  • KIYOSUE Hiro
    Department of Radiology, Oita University Faculty of Medicine
  • HORI Yuzo
    Department of Radiology, Nagatomi Neurosurgical Hospital
  • KASHIWAGI Junji
    Department of Radiology, Oita University Faculty of Medicine
  • SAGARA Yoshiko
    Department of Radiology, Oita University Faculty of Medicine
  • TANOUE Shuichi
    Department of Radiology, Oita University Faculty of Medicine
  • OKAHARA Mika
    Department of Radiology, Oita University Faculty of Medicine
  • NAGATOMI Hirofumi
    Department of Neurosurgery, Nagatomi Neurosurgical Hospital
  • MORI Hiromu
    Department of Radiology, Oita University Faculty of Medicine

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Other Title
  • 骨内病変を伴った舌下神経管部硬膜動静脈瘻の一例

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Dural arteriovenous fistulas (AVFs) involving the hypoglossal canal and adjacent bony structure are relatively rare. The authors describe a case of 58-year-old male presenting with a pulse-synchronous tinnitus associated with a dural AVF involving the hypoglossal canal. Source images of MR angiography showed abnormal flow signal in the region of the hypoglossal canal with an intraosseous component. A CT scan revealed dilatation of the hypoglossal canal and a venous pouch with bone erosion. 3D-DSA showed the dural AVF in which numerous intraosseous arteriovenous fistulas draining into a venous pouch located posterolateral to the anterior condylar vein. Venous drainage routes were antegrade drainage to the jugular vein and the suboccipital cavernous sinus, and retrograde drainage into the transverse-sigmoid sinus and the cavernous sinus via the inferior petrosal sinus. The lesion was successfully treated by selective transvenous coil embolization, with all symptoms disappearing.

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