Posterior Meningeal Artery Origin Patterns among 300 Cases and Their Clinical Importance

J Stroke Cerebrovasc Dis. 2018 Jul;27(7):2032-2034. doi: 10.1016/j.jstrokecerebrovasdis.2018.02.059. Epub 2018 Mar 26.

Abstract

Background and purpose: The posterior meningeal artery (PMA) is known as a dura mater-nourishing vessel. We encountered a patient with Wallenberg syndrome during transarterial embolization of the PMA associated with the dural arteriovenous fistula (DAVF).

Methods: After development of Wallenberg syndrome in the patient, we assessed origins of the PMA patterns in 300 cases and divided them into 3 types.

Case presentation: A 63-year-old man was incidentally diagnosed as having transverse-sigmoid sinus DAVF with a cortical venous reflux. During the transarterial embolization, the patient complained of vertigo and numbness of the right extremities. Postoperatively, the patient exhibited Wallenberg syndrome. Diffusion-weighted magnetic resonance imaging showed a high-intensity area on the lateral side of the right medulla.

Conclusions: While performing arterial embolization of the PMA that directly originates from the intracranial vertebral artery, the possibility of deficient brainstem nourishment must be considered.

Keywords: Dural arteriovenous fistula; Wallenberg syndrome; endovascular treatment; posterior meningeal artery.

Publication types

  • Case Reports

MeSH terms

  • Biological Variation, Individual
  • Diagnosis, Differential
  • Humans
  • Lateral Medullary Syndrome / diagnosis
  • Lateral Medullary Syndrome / diagnostic imaging
  • Lateral Medullary Syndrome / pathology*
  • Lateral Medullary Syndrome / surgery
  • Male
  • Meningeal Arteries / abnormalities*
  • Meningeal Arteries / anatomy & histology*
  • Meningeal Arteries / diagnostic imaging
  • Meningeal Arteries / surgery
  • Middle Aged
  • Vertebral Artery / abnormalities
  • Vertebral Artery / diagnostic imaging
  • Vertebral Artery / surgery