Extensive Brainstem Lesion and Cervical Myelopathy: Overcoming a Grim Prognosis - Case Report

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F25%3A10506032" target="_blank" >RIV/00064203:_____/25:10506032 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11130/25:10506032

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=Z..EzkJQi5" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=Z..EzkJQi5</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1159/000549322" target="_blank" >10.1159/000549322</a>

Result language

angličtina

Original language name

Extensive Brainstem Lesion and Cervical Myelopathy: Overcoming a Grim Prognosis - Case Report

Original language description

INTRODUCTION: Cognard-type V arteriovenous fistulas are rare forms of dural arteriovenous malformations. This specific subtype is characterised by spinal venous drainage into peri-medullary veins, which presents as progressive or ascending myelopathy in 50% of cases. CASE PRESENTATION: A 59-year-old man with 3 weeks of worsening quadriparesis, along with abnormal sensory findings, gait deterioration, and bowel and bladder dysfunction, was admitted to the hospital. MRI revealed extensive T2 hyper-intense signal changes in the brainstem and myelopathy in the cervical spinal cord extending down to C7. The differential diagnosis for extensive myelopathy and brainstem lesions seen on MRI included a tumour, autoimmune inflammation, and suspicion of vascular malformation. The administration of corticosteroids resulted in a worsening of the patient&apos;s neurological symptoms. Conventional angiography confirmed the presence of a dural AVF (a small arteriovenous short shunt receiving arterial supply from the middle meningeal and occipital artery) in the territory of the left external carotid artery. A minimally invasive endovascular treatment was successfully performed. CONCLUSION: We present this case considering that only 100 patients with Cognard type V fistula have been reported to date. Additionally, we aim to highlight the importance of caution when administering corticosteroids in cases of diagnostic uncertainty.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30103 - Neurosciences (including psychophysiology)

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Case Reports in Neurology

ISSN

1662-680X

e-ISSN

—

Volume of the periodical

17

Issue of the periodical within the volume

1

Country of publishing house

CH - SWITZERLAND

Number of pages

8

Pages from-to

168-175

UT code for WoS article

001632184900001

EID of the result in the Scopus database

2-s2.0-105027327098