Acquired Chiari Type I Malformation Associated with Type IV Dural Arteriovenous Fistula: Case Report

Abstract

Background Chiari malformations, usually congenital, can rarely be associated with arteriovenous (AV) fistulas. We present the first case involving a type IV dural AV fistula with a Chiari type I malformation.

Methods Retrospective chart review was performed to obtain pertinent details regarding history and examination, pathologic findings, and treatment course.

Results A 63-year-old woman with a 2-year history of migraines presented with 5 months of occipital, right-sided headaches and neck pain exacerbated by Valsalva maneuvers. Computed tomography (CT) and magnetic resonance imaging (MRI) of the head showed a possible right occipital AV malformation, bilateral cerebellar subdural hygromas, and tonsillar crowding at the foramen magnum indicating an acquired Chiari type I malformation. Angiography demonstrated a Cognardtype IV right posterior occipital dural AV fistula supplied by bilateral middle meningeal and posterior meningeal arteries.

Conclusion After treatment of the dural AV fistula, hygroma evacuation, and decompression of the acquired Chiari malformation, the patient's Valsalva-induced headaches abated.

Keywords

Chiari I malformation - acquiredchiari malformation - dural AV fistula - dural arteriovenous - case report

Author Contribution

D.D.L., N.A., and R.M.F. were involved in the design and conception of this manuscript. D.D.L. performed the literature search and acquired the data. D.D.L. and N.A. compiled the primary manuscript. D.D.L. and D.A.T. compiled the figures. M.M.M., E.G., D.A.T., and R.M.F. critically revised the manuscript. All authors have approved the manuscript as it is written.

Publication History

Received: 05 June 2021

Accepted: 03 March 2022

Accepted Manuscript online:
09 March 2022

Article published online:
04 July 2022

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