{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:09:07Z","timestamp":1775840947206,"version":"3.50.1"},"reference-count":14,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Cavernous sinus dural arteriovenous fistula (CSDAVF) is an abnormal arteriovenous connection involving the dura mater within or adjacent to the wall of the cavernous sinus. While cases with superior ophthalmic vein drainage and ocular symptoms are typical, we report a rare case of CSDAVF draining into the perimedullary vein of the medulla oblongata and spinal cord and causing cerebellar ataxia and myelopathy as the initial presentation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 73-year-old man presented with vertigo and rapidly progressing gait disturbance. Digital subtraction angiography revealed a left CSDAVF draining only into the spinal perimedullary veins, which was classified as Cognard type V. We performed a transvenous embolization through the occluded left inferior petrosal sinus and achieved a super-selective shunt occlusion using three platinum coils. The postoperative course was uneventful with immediate improvement of symptoms.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>CSDAVF should be considered as a differential diagnosis in a patient with venous congestion in the brainstem.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_637_2024","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T10:42:17Z","timestamp":1728038537000},"page":"359","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Brainstem congestion as the initial presentation of cavernous sinus dural arteriovenous fistula without ocular symptoms"],"prefix":"10.25259","volume":"15","author":[{"given":"Hiroki","family":"Goto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Fujita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoto","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaaki","family":"Kohta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Sasayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"10.25259\/SNI_637_2024\/ref-1","doi-asserted-by":"crossref","first-page":"839","DOI":"10.3171\/jns.1990.72.6.0839","article-title":"Intracranial dural arteriovenous malformations: Factors predisposing to an aggressive neurological course","volume":"72","author":"Awad","year":"1990","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_637_2024\/ref-2","doi-asserted-by":"crossref","first-page":"3457","DOI":"10.1007\/s10072-023-06870-1","article-title":"Watch brain circulation in unexplained progressive myelopathy: A review of Cognard type V arteriovenous fistulas","volume":"44","author":"De Grado","year":"2023","journal-title":"Neurol Sci"},{"key":"10.25259\/SNI_637_2024\/ref-3","doi-asserted-by":"crossref","first-page":"526550","DOI":"10.3389\/fneur.2020.526550","article-title":"Intracranial dural arteriovenous fistulas with brainstem engorgement: An under-recognized entity in diagnosis and treatment","volume":"11","author":"Hou","year":"2020","journal-title":"Front Neurol"},{"key":"10.25259\/SNI_637_2024\/ref-4","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.surneu.2005.06.044","article-title":"Cavernous sinus dural arteriovenous fistula complicated by pontine venous congestion. A case report","volume":"65","author":"Iwasaki","year":"2006","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_637_2024\/ref-5","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1007\/s00701-004-0315-3","article-title":"Brain stem venous congestion due to dural arteriovenous fistulas of the cavernous sinus","volume":"146","author":"Kai","year":"2004","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_637_2024\/ref-6","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s00234-008-0486-3","article-title":"Basal cerebral venous drainage from cavernous sinus dural arteriovenous fistulas","volume":"51","author":"Kiyosue","year":"2009","journal-title":"Neuroradiology"},{"key":"10.25259\/SNI_637_2024\/ref-7","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1016\/j.jocn.2008.12.031","article-title":"Carotid cavernous fistula with cervical myelopathy","volume":"16","author":"Ko","year":"2009","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI_637_2024\/ref-8","doi-asserted-by":"crossref","first-page":"724","DOI":"10.3171\/jns.1986.64.5.0724","article-title":"Neurological manifestations of intracranial dural arteriovenous malformations","volume":"64","author":"Lasjaunias","year":"1986","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_637_2024\/ref-9","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4103\/2152-7806.96076","article-title":"Pontine venous congestion due to dural arteriovenous fistula of the cavernous sinus: Case report and review of the literature","volume":"3","author":"Miyagishima","year":"2012","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_637_2024\/ref-10","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.wneu.2020.04.165","article-title":"Cavernous sinus dural arteriovenous fistula with an enhanced lesion in the brainstem mimicking a malignant tumor","volume":"140","author":"Nambu","year":"2020","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_637_2024\/ref-11","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s002340050846","article-title":"Intracranial dural arteriovenous fistulae with perimedullary venous drainage. Anatomical, clinical and therapeutic considerations","volume":"41","author":"Ricolfi","year":"1999","journal-title":"Neuroradiology"},{"key":"10.25259\/SNI_637_2024\/ref-12","first-page":"886","article-title":"Dural arteriovenous fistula of the cavernous sinus with venous congestion of the brain stem: Report of two cases from the Departments of Radiology","volume":"20","author":"Takahashi","year":"1999","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_637_2024\/ref-13","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_637_2024\/ref-14","doi-asserted-by":"crossref","first-page":"976","DOI":"10.3171\/jns.1984.60.5.0976","article-title":"Spontaneous carotid-cavernous fistulas: Clinical, radiological, and therapeutic considerations: Experience with 20 cases","volume":"60","author":"Vi\u00f1uela","year":"1984","journal-title":"J Neurosurg"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/brainstem-congestion-as-the-initial-presentation-of-cavernous-sinus-dural-arteriovenous-fistula-without-ocular-symptoms\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/brainstem-congestion-as-the-initial-presentation-of-cavernous-sinus-dural-arteriovenous-fistula-without-ocular-symptoms\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T10:42:23Z","timestamp":1728038543000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/brainstem-congestion-as-the-initial-presentation-of-cavernous-sinus-dural-arteriovenous-fistula-without-ocular-symptoms\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,4]]},"references-count":14,"alternative-id":["10.25259\/SNI_637_2024"],"URL":"https:\/\/doi.org\/10.25259\/sni_637_2024","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2024,10,4]]},"article-number":"359"}}