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Treatment of high cervical arteriovenous fistulas in the craniocervical junction region
The craniocervical junction (CCJ) is a complex region. Rarely, arteriovenous fistulas (AVFs) can occur in the CCJ region. Currently, it is accepted that CCJ AVFs should only refer to AVFs at the C1-C2 levels. It is reasonable to assume that high cervical CCJ AVFs are being referred to when discussin...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10335834/ https://www.ncbi.nlm.nih.gov/pubmed/37441609 http://dx.doi.org/10.3389/fneur.2023.1164548 |
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author | Su, Han Yu, Jinlu |
author_facet | Su, Han Yu, Jinlu |
author_sort | Su, Han |
collection | PubMed |
description | The craniocervical junction (CCJ) is a complex region. Rarely, arteriovenous fistulas (AVFs) can occur in the CCJ region. Currently, it is accepted that CCJ AVFs should only refer to AVFs at the C1-C2 levels. It is reasonable to assume that high cervical CCJ AVFs are being referred to when discussing CCJ AVFs. High cervical CCJ AVFs can be divided into the following four types: dural AVF, radicular AVF, epidural AVF and perimedullary AVF. Until now, it was difficult to understand high cervical CCJ AVFs and provide a proper treatment for them. Therefore, an updated review of high cervical CCJ AVFs is necessary. In this review, the following issues are discussed: the definition of high cervical CCJ AVFs, vessel anatomy of the CCJ region, angioarchitecture of high cervical CCJ AVFs, treatment options, prognoses and complications. Based on the review and our experience, we found that the four types of high cervical CCJ AVFs share similar clinical and imaging characteristics. Patients may present with intracranial hemorrhage or congestive myelopathy. Treatment, including open surgery and endovascular treatment (EVT), can be used for symptomatic AVFs. Most high cervical CCJ AVFs can be effectively treated with open surgery. EVT remains challenging due to a high rate of incomplete obliteration and complications, and it can only be performed in superselective AVFs with simple angioarchitecture. Appropriate treatment can lead to a good prognosis. |
format | Online Article Text |
id | pubmed-10335834 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-103358342023-07-12 Treatment of high cervical arteriovenous fistulas in the craniocervical junction region Su, Han Yu, Jinlu Front Neurol Neurology The craniocervical junction (CCJ) is a complex region. Rarely, arteriovenous fistulas (AVFs) can occur in the CCJ region. Currently, it is accepted that CCJ AVFs should only refer to AVFs at the C1-C2 levels. It is reasonable to assume that high cervical CCJ AVFs are being referred to when discussing CCJ AVFs. High cervical CCJ AVFs can be divided into the following four types: dural AVF, radicular AVF, epidural AVF and perimedullary AVF. Until now, it was difficult to understand high cervical CCJ AVFs and provide a proper treatment for them. Therefore, an updated review of high cervical CCJ AVFs is necessary. In this review, the following issues are discussed: the definition of high cervical CCJ AVFs, vessel anatomy of the CCJ region, angioarchitecture of high cervical CCJ AVFs, treatment options, prognoses and complications. Based on the review and our experience, we found that the four types of high cervical CCJ AVFs share similar clinical and imaging characteristics. Patients may present with intracranial hemorrhage or congestive myelopathy. Treatment, including open surgery and endovascular treatment (EVT), can be used for symptomatic AVFs. Most high cervical CCJ AVFs can be effectively treated with open surgery. EVT remains challenging due to a high rate of incomplete obliteration and complications, and it can only be performed in superselective AVFs with simple angioarchitecture. Appropriate treatment can lead to a good prognosis. Frontiers Media S.A. 2023-06-27 /pmc/articles/PMC10335834/ /pubmed/37441609 http://dx.doi.org/10.3389/fneur.2023.1164548 Text en Copyright © 2023 Su and Yu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Su, Han Yu, Jinlu Treatment of high cervical arteriovenous fistulas in the craniocervical junction region |
title | Treatment of high cervical arteriovenous fistulas in the craniocervical junction region |
title_full | Treatment of high cervical arteriovenous fistulas in the craniocervical junction region |
title_fullStr | Treatment of high cervical arteriovenous fistulas in the craniocervical junction region |
title_full_unstemmed | Treatment of high cervical arteriovenous fistulas in the craniocervical junction region |
title_short | Treatment of high cervical arteriovenous fistulas in the craniocervical junction region |
title_sort | treatment of high cervical arteriovenous fistulas in the craniocervical junction region |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10335834/ https://www.ncbi.nlm.nih.gov/pubmed/37441609 http://dx.doi.org/10.3389/fneur.2023.1164548 |
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