PMC5364925_01
A: Spine sagittal T2-wighted MRI showing an high intensity in dorsal surface between C2-C4 levels (white arrowhead). B: Sagittal gadolinium-enhanced cervical MRI shows the perimedullary vein (white arrow). C, D: Left external carotid angiograms, anteroposterior (C) and lateral (D) views, shows a left tranverse-sigmoid sinus dural arteriovenous fistula supplied by the left middle meningeal artery and occipital artery. Venous drainage is contralateral transverse sinus and anterior spinal perimedullary vein through superior petrosal sinus (black arrow). Other drainage route in C-2 level is internal vertebral venous plexus and radiculospinal vein through radiculomedullary vein (black arrowhead). E: Left common carotid angiogram (lateral view) after embolization shows no contrast filling of the dural arteriovenous fistula. F: 1 month after embolization, T2-weighted MRI of cervical spinal cord showed the cervical high intensity region was improved gradually. G: Cervical high intensity region was disappeared 1 year after embolization. MRI: magnetic resonance imaging.
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F1
C2 and C4 levels (Fig. 1A, B). Cervical enhanced MRI revealed serpentine vessels around the cervical spinal cord and medulla oblongata. This dural AVF drainage occurred through the right jugular vein through the left transverse sinus, confluence, right transverse sinus, and right sigmoid sinus (Fig. 1C, D). T2WI revealed a remarkably decreased extent of high intensity. The symptoms of dysesthesia and hypalgesia improved gradually (Fig. 1E-G).