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Occipital Neuralgia As a Presenting Symptom of Cervicomedullary Dural Arteriovenous Fistula


  • Akihito Hashiguchi MD, PhD,

  • Chikara Mimata MD, PhD,

  • Homare Ichimura MD,

  • Jun-Ichi Kuratsu MD, PhD

  • From the Shinbeppu Hospital—Neurosurgery, Beppu, Japan (Drs. Hashiguchi, Mimata, and Ichimura); and Faculty of Medical and Pharmaceutical Sciences, Kumamoto University Graduate School—Neurosurgery, Kumamoto, Japan (Dr. Kuratsu).

Address all correspondence to Akihito Hashiguchi, Shinbeppu Hospital–Neurosurgery, Tsurumi 3898, Beppu 874–0833, Japan.


Dural arteriovenous fistulas (DAVFs) at the cervicomedullary junction are rare and have a wide variation in presentation. We report a case of occipital neuralgia (ON) as a rare presenting symptom of cervicomedullary DAVF causing intramedullary hemorrhage at the C1 level. It is important to consider the underlying causes of ON, and precise neurological examinations and radiological evaluations are needed.