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논문 기본 정보

자료유형
학술저널
저자정보
Kim Dong Jin (Department of Neurosurgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Park Wonhyoung (Department of Neurosurgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Park Jung Cheol (Department of Neurosurgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Ahn Jae Sung (Department of Neurosurgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Lee Deok Hee (University of Ulsan) Byun Joonho (Department of Neurosurgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea)
저널정보
대한뇌혈관외과학회 Journal of Cerebrovascular and Endovascular Neurosurgery Journal of Cerebrovascular and Endovascular Neurosurgery Vol.23 No.1
발행연도
2021.3
수록면
41 - 48 (8page)
DOI
10.7461/jcen.2020.E2020.08.001

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We report a case of lateral cavernous sinus wall dural arteriovenous fistula (DAVF) accompanied large venous aneurysm which is presented intracerebral hemorrhage (ICH). A 58-year-old male patient came to emergency department for acute onset of headache and dysarthria. In brain computed tomography scan, large left temporal lobe ICH was noted. In transfemoral cerebral angiography, multiple arteries from external carotid artery and left internal carotid artery (ICA) fed arteriovenous shunt. This shunt was drained through cavernous sinus with enlarged multiple cortical veins. One large venous aneurysm was estimated as bleeding focus for ICH. Considering ICH and high flow shunt, we planned urgent treatment to reduce flow of arteriovenous shunt. However, transvenous embolization was failed due to tortuous venous anatomy. Therefore, we planned craniotomy and microsurgical treatment. There was engorged small vessel in lateral wall of cavernous sinus and vascular trunk which is fistulous connection was noted. Fistula connection was obliterated and disconnected after coagulation. In postoperative image, fistula was completely disappeared and there was no cortical venous reflux, also large venous aneurysm was disappeared. Patient recovered very well without new neurological deficits. We reported successfully treated lateral cavernous sinus wall DAVF by combined endovascular and transcranial-microsurgical treatment.
#?Dural arteriovenous fistula #Microsurgery #Cavernous sinus #Venous aneurysm

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참고문헌 (10)

참고문헌 신청
Borden JA / 1995 / A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment / J Neurosurg 82(2):166~179 google schola Cognard C / 2008 / Endovascular treatment of intracranial dural arteriovenous fistulas with cortical venous drainage : new management using Onyx / AJNR Am J Neuroradiol 29(2):235~241 google schola Daniels DJ / 2013 / Intracranial hemorrhage from dural arteriovenous fistulas : clinical features and outcome / Neurosurg Focus 34(5):E15 google schola Gandhi D / 2012 / Intracranial dural arteriovenous fistulas : classification, imaging findings, and treatment / AJNR Am J Neuroradiol 33(6):1007~1013 google schola Lamin S / 2017 / Embolization of intracranial dural arteriovenous fistulas using PHIL liquid embolic agent in 26 patients : a multicenter study / AJNR Am J Neuroradiol 38(1):127~131 google schola

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