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Alternative route to a hypoglossal canal dural arteriovenous fistula in case of failed jugular vein approach

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Hypoglossal canal dural arteriovenous fistulas (HC-DAVF) involve the anterior condylar vein (ACV) and anterior condylar confluence (ACC). They often present with tinnitus, bruit, and hypoglossal nerve palsy. The most common treatment in HC-DAVFs is transvenous embolization using coils and the most direct transvenous route is the trans-internal jugular vein access. When this approach is not feasible, a treatment attempt is possible through alternative routes. We report 2 patients with DAVFs involving the anterior condylar confluence. The first patient presented with pulsatile tinnitus and hypoglossal nerve palsy, and was treated by a standard transjugular approach. The second patient presented with pulse-synchronous bruit. Following an unsuccessful attempt of the transjugular approach, the fistulous point was reached via the deep cervical vein and complete occlusion was achieved by coil deployment. Both patients had complete regression of symptoms. Endovascular therapy is the elective treatment for HC-DAVFs and the transjugular approach is the most commonly used. The deep cervical vein (DCV) can be an alternative transvenous route when the transjugular approach fails.

Original languageEnglish
JournalInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
Volume27
Issue number2
Pages (from-to)275-280
Number of pages6
ISSN1123-9344
DOIs
Publication statusPublished - Apr 2021

    Research areas

  • anterior condylar confluence, anterior condylar vein, Dural arteriovenous fistula, hypoglossal canal, transvenous embolization

ID: 66479198