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Endovascular Therapy of Hypoglossal Canal AVFs Presenting with Orbital Symptoms

Published online by Cambridge University Press:  02 December 2014

Vladislav Miropolsky ,
Leodante B. da Costa ,
Thomas R. Marotta  and
Julian Spears
Vladislav Miropolsky
Affiliation:
St. Michael's Hospital, Department of Medical Imaging, University of Toronto
Leodante B. da Costa
Affiliation:
Division of Neurosurgery, Sunnybrook Hospital, Toronto, Ontario
Thomas R. Marotta
Affiliation:
Diagnostic & Therapeutic Neuroradiology, University of Toronto
Julian Spears*
Affiliation:
Division of Neurosurgery, University of Toronto
*
Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Suite 1005, 2 Queen Street East, Toronto, Ontario, M5C 3G7, Canada.
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Abstract

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Objective:

Dural arteriovenous fistulae (DAVF) of the hypoglossal canal region are rare lesions. We describe three cases of DAVF of the hypoglossal canal presenting with ocular symptoms and discuss the endovascular management options.

Methods:

Three consecutive patients with DAVF of the hypoglossal canal region presented with proptosis, chemosis and disturbances of extra-ocular mobility. Each patient was treated using a different endovascular approach, based on variations of the vascular access.

Results:

The cases and treatments are reviewed, with a literature review on the subject. Endovascular treatment, transvenous or trans-arterial was curative in all cases.

Conclusion:

DAVF of the hypoglossal canal region can present with ocular manifestations very similar to DAVF of the cavernous sinus or carotid-cavernous fistulas. Endovascular treatment is usually feasible and effective, but an understanding of the vascular anatomy and pathophysiology of the disease are of utmost importance when planning the approach.

Type
Other
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 6 , November 2009 , pp. 745 - 750
Copyright
Copyright © The Canadian Journal of Neurological 2009

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