Table 1: Literature review of lower cervical spinal dural arteriovenous fistulas.
Authors | Gender/Age | Side/Level | Main arterial feeder | Symptoms and signs | Location of venous congestion | Associating aneurysm | Treatment | Neurological outcome |
Willinsky, et al. 1990 [14] |
M/36 |
R/C8 |
VA, Costocervical trunk |
SAH, progressive quadriparesis, BBD |
C |
Yes (V) |
1. Embolization with NBCA. 2. Surgery (anterior) 3. Surgery (posterior) |
Walking with a cane |
Barnwell, et al. 1991 [15] |
F/69 |
R/C7 |
Costocervical trunk |
Arm and leg myelopathy |
N/A |
No |
1. Surgery at C1-C2 level 2. Surgery at C6-C7 level |
Not improved and died 4 months later |
Terao, et al. 2006 [16] |
M/69 |
L/C7 |
VA |
Acute dizziness, orthostatic hypotension, progressive myelopathy, respiratory dysfunction |
C, M |
No |
1. Coil embolization 2. Surgical disconnection |
Mild motor weakness of both legs and urinary difficulty remained evident. |
Geibprasert, et al. 2009 [10] |
M/51 |
L/C5 |
VA |
Progressive paraparesis, BBD |
T |
No |
Embolization with NBCA. |
Only mild left foot drop remaining |
Lucas, et al. 2012 [17] |
M/45 |
R/C5 |
VA |
SAH |
N/A |
Yes (A) |
Surgical ligation of the fistula and resection of the radiculopial artery aneurysm |
Nearly complete recovery |
Hetts, et al. 2013 [18] |
M/40 |
Bilateral/C6 |
Costocervical trunks |
Acute quadriparesis after a febrile illness, pain, BBD |
Mi, P, M, C, T |
No |
1. Surgical clipping of intradural vessel in posterior fossa 2. Surgical clipping of fistulas at both C5-6 level |
Slow improvement |
Pülhorn, et al. 2018 [19] |
F/42 |
L/C4 |
VA |
Intracranial hypertension |
N/A |
No |
Surgical excision of the fistula. |
Good improvement |
Gao, et al. 2019 [20] |
M/39 |
R/C5 |
Thyrocervical trunk |
SAH |
N/A |
Yes (A) |
Embolization of aneurysm Surgical interruption of the fistula |
N/A |
Present study, et al. 2019 |
F/34 |
R/C8 |
Costocervical trunk |
Progressive myelopathy, BBD, respiratory dysfunction |
M, C, T |
Yes (V) |
Embolization with NBCA. |
Paraparesis remaining |
A: arterial aneurysm; BBD: bowel and bladder dysfunction; C: cervical; F: female; M: male; R: right; L: left; M: medulla oblongata; Mi: midbrain; N/A: data not available; NBCA: N-butyl-2-cyanoacrylate; P: pons; SAH: subarachnoid hemorrhage; T: thoracic; V: venous aneurysm; VA: vertebral artery.