• Svetlana Kvint, Preethi Ramchand, Mougnyan Cox, Neda I Sedora-Roman, Linda Bagley, Donald M O'Rourke, Robert W Hurst, and Omar A Choudhri.
• Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: Svetlana.Kvint@pennmedicine.upenn.edu.
• World Neurosurg. 2020 May 1; 137: 55-61.

BackgroundThe artery of Wollschlaeger and Wollschlaeger is a tentorial branch of the superior cerebellar artery that is usually not visualized on conventional cerebral angiography, unless it is pathologically enlarged. It can be recruited as part of the blood supply to tentorial dural arteriovenous fistulas (AVFs), although this occurs infrequently.Case DescriptionHere we report the clinico-radiologic evaluation and treatment of a 48-year-old man referred to our institution for hitherto workup negative progressive, relapsing quadriparesis. This represents the first reported case of cervical myelopathy caused by venous congestion from a type V dural AVF supplied by the artery of Wollschlaeger and Wollschlaeger.ConclusionsThe anatomic discrepancy between the symptomatic spinal cord lesion and the etiologic intracranial fistula frequently results in delayed care in cases of myelopathy due to intracranial dural AVFs. Familiarity with these disorders and of their pathophysiologic mechanisms is important to avoid unnecessary diagnostic delays.Copyright © 2020 Elsevier Inc. All rights reserved.

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