Subarachnoid hemorrhage due to a craniocervical junction arteriovenous fistula associated with thrombus formation in the internal jugular vein: illustrative case
Subarachnoid hemorrhage due to a craniocervical junction arteriovenous fistula associated with thrombus formation in the internal jugular vein: illustrative case
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DOI：
10.3171/case22278
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发表时间：
2022-09
期刊：
影响因子：
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通讯作者：
Eri Shiozaki;Y. Morofuji;Fumiya Kutsuna;D. Uchida;I. Kawahara;Tomonori Ono;W. Haraguchi;K. Tsutsumi
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文献类型：
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作者：
Eri Shiozaki;Y. Morofuji;Fumiya Kutsuna;D. Uchida;I. Kawahara;Tomonori Ono;W. Haraguchi;K. Tsutsumi
颅颈交界动静脉瘘是一种罕见的血管畸形，其病因尚不清楚。在这里，据作者所知，他们提出了首例CCJAVF与同侧颈内静脉血栓形成相关的病例。一位80岁男性突发枕部头痛。计算机断层扫描显示脑干和上颈髓周围有蛛网膜下腔出血。数字减影血管造影显示CCJAVF由左侧C2网膜根动脉供血，颅内引流和硬膜外神经丛上升。经血管内治疗后，作者回顾性发现他入院时同侧颈内静脉和无名静脉被巨大的血栓阻塞。结论：该病例提示由于血栓诱导的进行性逆行颅内引流引起出血，导致顺行静脉血流受限。静脉高压应被认为是CCJAVF和颅内动静脉瘘出血的原因之一。
BACKGROUND A craniocervical junction arteriovenous fistula (CCJAVF) is a rare vascular malformation, and its etiology remains unclear. Here, to the best of the authors’ knowledge, they present the first case of CCJAVF associated with thrombus formation in the ipsilateral internal jugular vein. OBSERVATIONS An 80-year-old man presented with a sudden occipital headache. Computed tomography revealed a subarachnoid hemorrhage surrounding the brainstem and upper cervical cord. Digital subtraction angiography showed a CCJAVF fed by the left C2 radiculomeningeal artery with ascending intracranial drainage and epidural plexus. After endovascular treatment, the authors retrospectively found that his ipsilateral internal jugular vein and innominate vein were occluded with a huge thrombus at admission. LESSONS This case suggested a restricted antegrade venous flow due to thrombus-induced progressive retrograde intracranial drainage causing hemorrhage. Venous hypertension should be considered one of the causes of hemorrhage due to CCJAVF as well as intracranial arteriovenous fistulas.