{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T22:10:33Z","timestamp":1781820633404,"version":"3.54.5"},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nThe findings of a hyperintense sign on T2-weighted imaging (T2-WI) and gadolinium (Gd) contrast enhancement on magnetic resonance imaging (MRI) of the brain stem suggest malignant glioma. However, this pathological condition is probably uncommon, and it may be unknown that a dural arteriovenous fistula (DAVF) can imitate this radiological pattern. In addition, it is extremely rare to be caused by a spinal DAVF. Here, a rare case of spinal DAVF that mimicked malignant glioma of the medulla oblongata is presented.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nA 56-year-old woman was admitted with a progressive gait disturbance, vertigo, and dysphasia. MRI showed a hyperintense signal in the medulla oblongata on fluid-attenuated inversion recovery (FLAIR) and moderate contrast enhancement on Gd-enhanced MRI. Interestingly, Gd-enhanced MRI demonstrated abnormal dilated veins around the brain stem and cervical spinal cord. Cerebral angiography showed spinal DAVF at the left C4\/C5 vertebral foramen fed by the C5 radicular artery. The fistula drained into spinal perimedullary veins and flowed out retrograde at the cortical vein of the posterior cranial fossa. Therefore, surgical disconnection of the spinal DAVF was performed by a posterior approach. The patient\u2019s postoperative course was uneventful. Cerebral angiography showed complete disappearance of the DAVF, with marked reductions of the hyperintense sign of the medulla oblongata on FLAIR.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nThis important case illustrates MRI findings mimicking brain stem glioma. In cases with the hyperintense sign-on T2-WI associated with contrast enhancement suspicious of brainstem glioma, careful checking for perimedullary abnormal vessels and additional cerebral angiography should be performed.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_437_2020","type":"journal-article","created":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T07:54:07Z","timestamp":1599897247000},"page":"287","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A rare case of spinal dural arteriovenous fistula mimicking malignant glioma of the medulla oblongata: Significance of cerebral angiography for accurate diagnosis of brain stem region"],"prefix":"10.25259","volume":"11","author":[{"given":"Seiji","family":"Shigekawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawara","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Kohno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Tagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeharu","family":"Kunieda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2020,9,12]]},"reference":[{"key":"10.25259\/SNI_437_2020\/ref-1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1590\/0100-3984.2015.0046","article-title":"Pulmonary artery sarcoma mimicking chronic pulmonary thromboembolism","volume":"4","author":"Batista","year":"2015","journal-title":"Radiol Bras"},{"key":"10.25259\/SNI_437_2020\/ref-2","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.wneu.2018.02.161","article-title":"Lessons to be remembered from a dural arteriovenous fistula mimicking medulla and high cervical cord glioma","volume":"113","author":"Bernard","year":"2018","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_437_2020\/ref-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":"10.25259\/SNI_437_2020\/ref-4","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1053\/j.sult.2010.03.002","article-title":"Differential diagnosis of T2 hyperintense brainstem lesions: Part 2. Diffuse lesions","volume":"31","author":"Guzm\u00e1n-De-Villoria","year":"2010","journal-title":"Semin Ultrasound CT MR"},{"key":"10.25259\/SNI_437_2020\/ref-5","doi-asserted-by":"crossref","first-page":"E135","DOI":"10.1227\/NEU.0000000000000069","article-title":"Cognard type V intracranial dural arteriovenous shunt: Case reports and literature review with special consideration of the pattern of spinal venous drainage","volume":"74","author":"Haryu","year":"2014","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_437_2020\/ref-6","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1111\/jon.12220","article-title":"Dural arteriovenous fistula mimicking a brainstem glioma","volume":"25","author":"Le Guennec","year":"2015","journal-title":"J Neuroimaging"},{"key":"10.25259\/SNI_437_2020\/ref-7","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.3171\/2014.11.JNS142278","article-title":"Unilateral contrast-enhancing pontomedullary lesion due to an intracranial dural arteriovenous fistula with perimedullary spinal venous drainage: The exception that proves the rule","volume":"123","author":"Roelz","year":"2015","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_437_2020\/ref-8","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.surneu.2004.12.029","article-title":"Brain stem ischemia from intracranial dural arteriovenous fistula: Case report","volume":"64","author":"Satoh","year":"2005","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_437_2020\/ref-9","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s003300050175","article-title":"Pontine venous congestion caused by dural carotid-cavernous fistula: Report of two cases","volume":"7","author":"Uchino","year":"1997","journal-title":"Eur Radiol"},{"key":"10.25259\/SNI_437_2020\/ref-10","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3340\/jkns.2014.55.3.152","article-title":"Brainstem congestion due to dural ateriovenous fistula at the craniocervical junction","volume":"55","author":"Wu","year":"2014","journal-title":"J Korean Neurosurg Soc"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/a-rare-case-of-spinal-dural-arteriovenous-fistula-mimicking-malignant-glioma-of-the-medulla-oblongata-significance-of-cerebral-angiography-for-accurate-diagnosis-of-brain-stem-region\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/a-rare-case-of-spinal-dural-arteriovenous-fistula-mimicking-malignant-glioma-of-the-medulla-oblongata-significance-of-cerebral-angiography-for-accurate-diagnosis-of-brain-stem-region\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T07:54:10Z","timestamp":1599897250000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/a-rare-case-of-spinal-dural-arteriovenous-fistula-mimicking-malignant-glioma-of-the-medulla-oblongata-significance-of-cerebral-angiography-for-accurate-diagnosis-of-brain-stem-region\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,12]]},"references-count":10,"alternative-id":["10.25259\/SNI_437_2020"],"URL":"https:\/\/doi.org\/10.25259\/sni_437_2020","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,12]]},"article-number":"287"}}