Title |
Dural Arteriovenous Fistulas: A Characteristic Pattern of Edema and Enhancement of the Medulla on MRI
|
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Published in |
American Journal of Neuroradiology, December 2017
|
DOI | 10.3174/ajnr.a5460 |
Pubmed ID | |
Authors |
A.Z. Copelan, A. Krishnan, H. Marin, R. Silbergleit |
Abstract |
Medullary edema with enhancement is rarely reported at initial MR imaging in intracranial dural arteriovenous fistulas. We report a series of 5 patients with dural arteriovenous fistulas, all of whom demonstrated a characteristic pattern of central medullary edema and medullary enhancement at initial MR imaging. Cognard type V dural arteriovenous fistula, defined by drainage into the perimedullary veins and the veins surrounding the brain stem, is a rare yet well-described pathologic entity. Even more rarely reported, however, is its clinical presentation with predominantly bulbar symptoms and MR imaging findings of central medullary edema with enhancement. This constellation of findings frequently leads to a convoluted clinical picture, prompting work-up for alternative disease processes and delaying diagnosis. Because an expedited diagnosis is critical in preventing poor outcomes, it is paramount to make the referring physician and neuroradiologist more cognizant of this rare-yet-characteristic imaging manifestation of dural arteriovenous fistula. |
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Spain | 11 | 33% |
United States | 9 | 27% |
Canada | 2 | 6% |
United Kingdom | 2 | 6% |
Netherlands | 1 | 3% |
Ecuador | 1 | 3% |
Unknown | 7 | 21% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 22 | 67% |
Practitioners (doctors, other healthcare professionals) | 6 | 18% |
Scientists | 4 | 12% |
Science communicators (journalists, bloggers, editors) | 1 | 3% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 26 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Other | 6 | 23% |
Student > Ph. D. Student | 3 | 12% |
Student > Doctoral Student | 2 | 8% |
Researcher | 2 | 8% |
Professor > Associate Professor | 2 | 8% |
Other | 5 | 19% |
Unknown | 6 | 23% |
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Nursing and Health Professions | 2 | 8% |
Neuroscience | 1 | 4% |
Computer Science | 1 | 4% |
Unknown | 7 | 27% |