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A 43-year-old woman with progressive gait disturbance and dysesthesia of the limbs and trunk visited our hospital. Upon examination, a thoracocervical giant perimedullary arteriovenous fistula(GPMAVF)was detected. The GPMAVF was fed by both of the highest intercostal arteries and the thyrocervical trunk. The dilated drainage vein widely compressed the spinal cord from the upper thoracic to the cervical regions. Transarterial embolization with n-butyl 2-cyanoacrylate was performed, and the fistula was completely obliterated. The dilated drainage vein was thrombosed, and it decreased in size after treatment. The patient's symptoms and magnetic resonance imaging results significantly improved. We suggest that endovascular treatment is effective for GPMAVFs, given sufficient analysis of the anatomical architecture.


Shinya Yamaguchi, Takeshi Hamamura, Osamu Ito, Tetsuro Sayama, Takafumi Shimogawa, Koichiro Matsukado, Takato Morioka. Thoracocervical giant perimedullary arteriovenous fistula treated with transarterial embolization: a case report]. No shinkei geka. Neurological surgery. 2013 Mar;41(3):247-53

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PMID: 23459523

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