{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:40:57Z","timestamp":1782448857313,"version":"3.54.5"},"reference-count":23,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2012,12,10]]},"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Extradural arteriovenous fistulae (AVFs) are vascular malformations that result from a direct connection between an extradural artery and vein, resulting in a high flow fistula that drains into the epidural venous system. Extradural AVFs may cause myelopathy when distended epidural veins compress the cord or when venous hypertension causes venous stasis within the spinal cord, and are uncommon causes of subarachnoid hemorrhage (SAH), although the presence of intracranial drainage is a risk factor for SAH. There are numerous reports of SAH and AVF with rostral intracranial venous drainage, implying an intradural drainage pathway. To our knowledge, a cervical spinal AVF at the craniovertebral junction (occurring between the occiput and C2) with exclusively extradural drainage and without a significant epidural component has not been described previously.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective review was performed identifying three patients treated at our hospital with cervical spinal AVF and extradural venous drainage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We present three cases of cervical spinal AVF with exclusive extradural venous drainage without accompanying intradural drainage\u2014cranial or spinal. All three patients with exclusively extradural drainage have done well after 24\u2005months of follow-up. The anatomical, clinical, and radiologic features are presented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with cervical AVF and exclusively extradural drainage pathways form a separate entity, representing a subset with a less ominous natural history.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2012-010589","type":"journal-article","created":{"date-parts":[[2013,1,11]],"date-time":"2013-01-11T20:47:03Z","timestamp":1357937223000},"page":"150-155","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Analysis of venous drainage in three patients with extradural spinal arteriovenous fistulae at the craniovertebral junction with potentially benign implication"],"prefix":"10.1136","volume":"6","author":[{"given":"Ajit S","family":"Puri","sequence":"first","affiliation":[{"name":"Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA"},{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas Alexander","family":"Telischak","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Vissapragada","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajith J","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,1,11]]},"reference":[{"key":"2025092911513140000_6.2.150.1","first-page":"749","article-title":"Paravertebral arteriovenous malformations with epidural drainage: clinical spectrum, imaging features, and results of treatment","volume":"20","author":"Goyal","year":"1999","journal-title":"AJNR Am J Neuroradiol"},{"issue":"(2 Suppl)","key":"2025092911513140000_6.2.150.2","first-page":"145","article-title":"Modified classification of spinal cord vascular lesions","volume":"96","author":"Spetzler","year":"2002","journal-title":"J Neurosurg"},{"key":"2025092911513140000_6.2.150.3","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1148\/radiology.194.3.7862961","article-title":"Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage","volume":"194","author":"Cognard","year":"1995","journal-title":"Radiology"},{"key":"2025092911513140000_6.2.150.4","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.82.2.0166"},{"key":"2025092911513140000_6.2.150.5","doi-asserted-by":"crossref","first-page":"830","DOI":"10.3171\/jns.1996.85.5.0830","article-title":"The validity of classification for the clinical presentation of intracranial dural arteriovenous fistulas","volume":"85","author":"Davies","year":"1996","journal-title":"J Neurosurg"},{"key":"2025092911513140000_6.2.150.6","doi-asserted-by":"crossref","unstructured":"Shah MN Botros JA Pilgram TK . Borden\u2013Shucart type I dural arteriovenous fistulas: clinical course including risk of conversion to higher-grade fistulas. J Neurosurg 117:539\u201345.","DOI":"10.3171\/2012.5.JNS111257"},{"key":"2025092911513140000_6.2.150.7","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.516757"},{"key":"2025092911513140000_6.2.150.8","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200106000-00043"},{"key":"2025092911513140000_6.2.150.9","doi-asserted-by":"crossref","first-page":"755","DOI":"10.3171\/jns.1998.89.5.0755","article-title":"Dural arteriovenous shunts at the craniocervical junction","volume":"89","author":"Kinouchi","year":"1998","journal-title":"J Neurosurg"},{"key":"2025092911513140000_6.2.150.10","first-page":"854","article-title":"Cervical dural arteriovenous fistulae manifesting as subarachnoid hemorrhage: report of two cases and literature review","volume":"25","author":"Aviv","year":"2004","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092911513140000_6.2.150.11","first-page":"1949","article-title":"Arteriovenous fistulas at the cervicomedullary junction presenting with subarachnoid hemorrhage: six case reports with special reference to the angiographic pattern of venous drainage","volume":"26","author":"Kai","year":"2005","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092911513140000_6.2.150.12","first-page":"348","article-title":"Dural arteriovenous fistula of the cervical spine presenting with subarachnoid hemorrhage","volume":"20","author":"Do","year":"1999","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092911513140000_6.2.150.13","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.49.108"},{"key":"2025092911513140000_6.2.150.14","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1177\/159101999900500304","article-title":"Spontaneous vertebrovertebral arteriovenous fistulae clinical features, angioarchitecture and management of twelve patients","volume":"5","author":"Goyal","year":"1999","journal-title":"Interv Neuroradiol"},{"key":"2025092911513140000_6.2.150.15","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/S0090-3019(96)00552-6","article-title":"Transcondylar approach for dural arteriovenous fistulas of the cervicomedullary junction","volume":"48","author":"Niwa","year":"1997","journal-title":"Surg Neurol"},{"key":"2025092911513140000_6.2.150.16","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2109"},{"key":"2025092911513140000_6.2.150.17","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000347091.06694.3E"},{"key":"2025092911513140000_6.2.150.18","doi-asserted-by":"publisher","DOI":"10.1007\/BF00344211"},{"key":"2025092911513140000_6.2.150.19","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1227\/NEU.0b013e3182274865","article-title":"History of the vertebral venous plexus and the significant contributinos of Breschet and Batson","volume":"69","author":"Nathoo","year":"2011","journal-title":"Neurosurgery"},{"key":"2025092911513140000_6.2.150.20","first-page":"53","article-title":"The cerebrospinal venous system: anatomy, physiology, and clinical implications","volume":"22","author":"Tobinick","year":"2006","journal-title":"MedGenMed"},{"key":"2025092911513140000_6.2.150.21","doi-asserted-by":"crossref","first-page":"252","DOI":"10.3171\/jns.1997.86.2.0252","article-title":"The suboccipital cavernous sinus","volume":"86","author":"Arnautovic","year":"1997","journal-title":"J Neurosurg"},{"key":"2025092911513140000_6.2.150.22","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-004-2597-5"},{"key":"2025092911513140000_6.2.150.23","doi-asserted-by":"crossref","first-page":"2514","DOI":"10.1161\/01.STR.29.12.2514","article-title":"MR imaging in pretruncal nonaneurysmal subarachnoid hemorrhage: is it worthwhile?","volume":"29","author":"Wijdicks EFM","year":"1998","journal-title":"Stroke"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2012-010589","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T18:51:39Z","timestamp":1759171899000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2012-010589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1,11]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2014,2,12]]},"published-print":{"date-parts":[[2014,3]]}},"alternative-id":["10.1136\/neurintsurg-2012-010589"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2012-010589","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,11]]}}}