Analysis of Microsurgical Occlusion Outcomes for Craniocervical Junction Spinal Dural Arteriovenous Fistulas Presenting With SAH.

Spinal dural arteriovenous fistula (SDAVF) is a common spinal vascular malformation predominantly occurring in the thoracolumbar region, and craniocervical junction SDAVF (CCJ-SDAVF) is rare. Endovascular interventional embolization and surgical severance of the fistula are the mainstay of treatment for this condition. We report a patient with acute subarachnoid hemorrhage (SAH) secondary to CCJ-SDAVF. We used microsurgery in this patient and successfully occluded the fistula with the help of intraoperative indocyanine green angiography (ICG-A) and occlusion test. The patient was reviewed 6 months after discharge, and the cranial digital subtraction angiography (DSA) showed complete occlusion of the fistula, and the cranial MRI showed relief of intramedullary hypertension and disappearance of perimedullary flow voids, with a satisfactory outcome. This report hopes that the successful cure of this case will provide some support for the diagnosis and treatment of CCJ-SDAVF.