{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:28:26Z","timestamp":1787668106969,"version":"build-2736575974"},"reference-count":9,"publisher":"Radiological Society of North America (RSNA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiology"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:p>History<\/jats:p>\n                  <jats:p>A 76-year-old man presented to the emergency department with a 1-month history of worsening binocular diplopia on left horizontal gaze, along with 1 week of progressive dysarthria and dizziness. Additionally, he had a chronic history of right-sided cervicobrachialgia related to degenerative disk disease, which had been improving with oral analgesia. The patient\u2019s past medical history included hypertension, dyslipidemia, insomnia, and hypothyroidism. He also had postpolio syndrome affecting the right lower limb. He reported no fever, chills, cough, shortness of breath, abdominal pain, or chest pain. There was no history of rash, intravenous drug use, immunosuppressive medication use, or documented congenital abnormalities. He reported no recent or recurrent bacterial or viral infections.<\/jats:p>\n                  <jats:p>\n                    At clinical examination, the patient appeared tired and had a decreased level of alertness. He was hypertensive (165\/91 mm Hg) but had a normal body temperature. Other vital signs were unremarkable. Neurologic assessment revealed left abducens nerve palsy, right lower facial palsy, horizontal nystagmus during right eye adduction, and right lower limb paresis with ipsilateral patellar hyperreflexia. Brain MRI performed the day after admission showed imaging abnormalities. Laboratory testing showed an elevated C-reactive protein level (135 mg\/L; upper limit of normal, 1 mg\/L); other blood tests were within normal limits. Extensive additional diagnostic workup\u2014including serologic testing for anti-aquaporin-4 antibody, anti-DNA antibody, lupus anticoagulant, antinuclear antibody, anti-cardiolipin antibody, and rheumatoid factor\u2014yielded negative results. Lumbar puncture revealed a normal cerebrospinal fluid opening pressure (18 cm H\n                    <jats:sub>2<\/jats:sub>\n                    O; upper limit of normal, 25 cm H\n                    <jats:sub>2<\/jats:sub>\n                    O). The cerebrospinal fluid was clear, with a normal total nucleated cell count (3.75\/mm\n                    <jats:sup>3<\/jats:sup>\n                    ; reference range, 0\u20135\/mm\n                    <jats:sup>3<\/jats:sup>\n                    ), normal glucose level (53 mg\/dL [2.9 mmol\/L]; reference range, 50\u201377 mg\/dL [2.8\u20134.3 mmol\/L]), and elevated total protein level (750 mg\/L; reference range, 100\u2013450 mg\/L). Cerebrospinal fluid oligoclonal bands were positive.\n                  <\/jats:p>","DOI":"10.1148\/radiol.252118","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:47:43Z","timestamp":1787665663000},"source":"Crossref","is-referenced-by-count":0,"title":["Case 349: Venous Infarction Secondary to Hypoglossal Canal Dural                     Arteriovenous Fistula"],"prefix":"10.1148","volume":"320","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8379-3178","authenticated-orcid":false,"given":"Matheus Hideki","family":"Taborda","sequence":"first","affiliation":[{"name":"Postgraduate Program, Federal University of                     Paran\u00e1, Rua General Carneiro 181, Curitiba, PR, Brazil 80060-900"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1166-9722","authenticated-orcid":false,"given":"Matheus Kahakura Franco","family":"Pedro","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Instituto de                     Neurologia de Curitiba, Curitiba, Brazil"},{"name":"Postgraduate Program, Pontif\u00edcia Universidade                     Federal do Paran\u00e1, Curitiba, Brazil"},{"name":"Department of Medicine, Faculdades Pequeno                     Pr\u00edncipe, Curitiba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4769-6562","authenticated-orcid":false,"given":"Bernardo","family":"Corr\u00eaa de Almeida Teixeira","sequence":"additional","affiliation":[{"name":"Postgraduate Program, Federal University of                     Paran\u00e1, Rua General Carneiro 181, Curitiba, PR, Brazil 80060-900"},{"name":"Radiology Unit, Hospital de Cl\u00ednicas da                     Universidade Federal do Paran\u00e1, Curitiba, Brazil"},{"name":"Department of Neuroradiology, Instituto de Neurologia de                     Curitiba, Curitiba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1577","reference":[{"issue":"10","key":"r1","first-page":"2016","volume":"20","author":"Ernst R","year":"1999","journal-title":"AJNR Am J Neuroradiol"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7152"},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-008-0393-7"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.3171\/2013.4.JNS121974"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.3171\/2014.10.JNS14377"},{"key":"r6","doi-asserted-by":"publisher","DOI":"10.1111\/jon199884210"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2001.tb00073.x"},{"key":"r8","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.49.359"},{"key":"r9","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213871"}],"container-title":["Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/pubs.rsna.org\/doi\/pdf\/10.1148\/radiol.252118","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:47:52Z","timestamp":1787665672000},"score":1,"resource":{"primary":{"URL":"http:\/\/pubs.rsna.org\/doi\/10.1148\/radiol.252118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,8,1]]}},"alternative-id":["10.1148\/radiol.252118"],"URL":"https:\/\/doi.org\/10.1148\/radiol.252118","relation":{},"ISSN":["0033-8419","1527-1315"],"issn-type":[{"value":"0033-8419","type":"print"},{"value":"1527-1315","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]},"article-number":"e252118"}}