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Cavernous Sinus Dural Arteriovenous Fistula Patients Presenting With Headache as an Initial Symptom

Cavernous sinus (CS) dural arteriovenous fistula (dAVF) patients presenting with only headache as an initial symptom are not common. Patients with CS-dAVF commonly present with symptoms related to their eyes. In all three patients, headache was the initial symptom. Other symptoms related to the eyes...

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Autores principales: Nomura, Motohiro, Mori, Kentaro, Tamase, Akira, Kamide, Tomoya, Seki, Syunsuke, Iida, Yu, Kawabata, Yuichi, Nakano, Tatsu, Shima, Hiroshi, Taguchi, Hiroki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780500/
https://www.ncbi.nlm.nih.gov/pubmed/26985257
http://dx.doi.org/10.14740/jocmr2489w
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author Nomura, Motohiro
Mori, Kentaro
Tamase, Akira
Kamide, Tomoya
Seki, Syunsuke
Iida, Yu
Kawabata, Yuichi
Nakano, Tatsu
Shima, Hiroshi
Taguchi, Hiroki
author_facet Nomura, Motohiro
Mori, Kentaro
Tamase, Akira
Kamide, Tomoya
Seki, Syunsuke
Iida, Yu
Kawabata, Yuichi
Nakano, Tatsu
Shima, Hiroshi
Taguchi, Hiroki
author_sort Nomura, Motohiro
collection PubMed
description Cavernous sinus (CS) dural arteriovenous fistula (dAVF) patients presenting with only headache as an initial symptom are not common. Patients with CS-dAVF commonly present with symptoms related to their eyes. In all three patients, headache was the initial symptom. Other symptoms related to the eyes developed 1 - 7 months after headache. In one patient, headache was controlled by sumatriptan succinate, but not diclofenac sodium or loxoprofen sodium. In another patient, headache was controlled by loxoprofen sodium. In the third patient, headache was improved by stellate ganglion block. In all patients, magnetic resonance angiography (MRA) in the early stage of the clinical course showed abnormal blood flow in the CS. However, reflux to the superior ophthalmic vein (SOV) was not detected. As treatment, transarterial and transvenous embolizations were necessary for one patient, and transvenous embolization was performed for another patient with significant blood flow to the SOV and cortical veins. On the other hand, manual compression of the bilateral carotid arteries at the neck resulted in disappearance of the fistula in the third patient. In all patients, the symptoms improved after the disappearance of blood reflux to the CS. The refluxed blood to the CS might cause elevation of the CS pressure and stimulate the trigeminal nerve in the dural membrane, resulting in headache before developing reflux in an anterior direction. CS-dAVF could induce both migraine and common headache. In cases with blood reflux to the CS on magnetic resonance imaging and/or MRA even without eye symptoms, a differential diagnosis of CS-dAVF should be taken into consideration.
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spelling pubmed-47805002016-03-16 Cavernous Sinus Dural Arteriovenous Fistula Patients Presenting With Headache as an Initial Symptom Nomura, Motohiro Mori, Kentaro Tamase, Akira Kamide, Tomoya Seki, Syunsuke Iida, Yu Kawabata, Yuichi Nakano, Tatsu Shima, Hiroshi Taguchi, Hiroki J Clin Med Res Case Report Cavernous sinus (CS) dural arteriovenous fistula (dAVF) patients presenting with only headache as an initial symptom are not common. Patients with CS-dAVF commonly present with symptoms related to their eyes. In all three patients, headache was the initial symptom. Other symptoms related to the eyes developed 1 - 7 months after headache. In one patient, headache was controlled by sumatriptan succinate, but not diclofenac sodium or loxoprofen sodium. In another patient, headache was controlled by loxoprofen sodium. In the third patient, headache was improved by stellate ganglion block. In all patients, magnetic resonance angiography (MRA) in the early stage of the clinical course showed abnormal blood flow in the CS. However, reflux to the superior ophthalmic vein (SOV) was not detected. As treatment, transarterial and transvenous embolizations were necessary for one patient, and transvenous embolization was performed for another patient with significant blood flow to the SOV and cortical veins. On the other hand, manual compression of the bilateral carotid arteries at the neck resulted in disappearance of the fistula in the third patient. In all patients, the symptoms improved after the disappearance of blood reflux to the CS. The refluxed blood to the CS might cause elevation of the CS pressure and stimulate the trigeminal nerve in the dural membrane, resulting in headache before developing reflux in an anterior direction. CS-dAVF could induce both migraine and common headache. In cases with blood reflux to the CS on magnetic resonance imaging and/or MRA even without eye symptoms, a differential diagnosis of CS-dAVF should be taken into consideration. Elmer Press 2016-04 2016-02-27 /pmc/articles/PMC4780500/ /pubmed/26985257 http://dx.doi.org/10.14740/jocmr2489w Text en Copyright 2016, Nomura et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Nomura, Motohiro
Mori, Kentaro
Tamase, Akira
Kamide, Tomoya
Seki, Syunsuke
Iida, Yu
Kawabata, Yuichi
Nakano, Tatsu
Shima, Hiroshi
Taguchi, Hiroki
Cavernous Sinus Dural Arteriovenous Fistula Patients Presenting With Headache as an Initial Symptom
title Cavernous Sinus Dural Arteriovenous Fistula Patients Presenting With Headache as an Initial Symptom
title_full Cavernous Sinus Dural Arteriovenous Fistula Patients Presenting With Headache as an Initial Symptom
title_fullStr Cavernous Sinus Dural Arteriovenous Fistula Patients Presenting With Headache as an Initial Symptom
title_full_unstemmed Cavernous Sinus Dural Arteriovenous Fistula Patients Presenting With Headache as an Initial Symptom
title_short Cavernous Sinus Dural Arteriovenous Fistula Patients Presenting With Headache as an Initial Symptom
title_sort cavernous sinus dural arteriovenous fistula patients presenting with headache as an initial symptom
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780500/
https://www.ncbi.nlm.nih.gov/pubmed/26985257
http://dx.doi.org/10.14740/jocmr2489w
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