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Traumatic Middle Meningeal Arteriovenous Fistula of Non-fractured Site Detected by Four-dimensional Computed Tomography Angiography: A Case Report

Middle meningeal arteriovenous fistula (MMAVF) of a non-fractured site is extremely rare, and the clinical characteristics are still unclear. We report a case of delayed onset of venous infarction due to an MMAVF following a fall accident. A 69-year-old man sustained multiple trauma due to a fall ac...

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Autores principales: Iki, Yusuke, Morofuji, Yoichi, Kanamoto, Tadashi, Horie, Nobutaka, Izumo, Tsuyoshi, Anda, Takeo, Matsuo, Takayuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162811/
https://www.ncbi.nlm.nih.gov/pubmed/32322452
http://dx.doi.org/10.2176/nmccrj.cr.2019-0185
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author Iki, Yusuke
Morofuji, Yoichi
Kanamoto, Tadashi
Horie, Nobutaka
Izumo, Tsuyoshi
Anda, Takeo
Matsuo, Takayuki
author_facet Iki, Yusuke
Morofuji, Yoichi
Kanamoto, Tadashi
Horie, Nobutaka
Izumo, Tsuyoshi
Anda, Takeo
Matsuo, Takayuki
author_sort Iki, Yusuke
collection PubMed
description Middle meningeal arteriovenous fistula (MMAVF) of a non-fractured site is extremely rare, and the clinical characteristics are still unclear. We report a case of delayed onset of venous infarction due to an MMAVF following a fall accident. A 69-year-old man sustained multiple trauma due to a fall accident. Head computed tomography (CT) showed traumatic subarachnoid hemorrhage, a left subdural hematoma, and skull fracture in his right temporal bone, all of which were managed conservatively. Five days after his admission, he suddenly exhibited total aphasia and right hemiparesis. Emergent CT revealed sporadic low-density areas in his left cerebral hemisphere, and four-dimensional CT angiography (4D-CTA) showed dilatation of the left middle meningeal artery and early venous drainage in the cavernous sinus and anterior temporal diploic vein (ATDV). A series of hemodynamics of 4D-CTA revealed early venous filling of ATDV interrelated with retrograde upward flow to high convexity in the venous phase. The MMAVF was successfully obliterated by transarterial coil embolization. We herein describe this case of MMAVF in which 4D-CTA was useful for the diagnosis.
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spelling pubmed-71628112020-04-22 Traumatic Middle Meningeal Arteriovenous Fistula of Non-fractured Site Detected by Four-dimensional Computed Tomography Angiography: A Case Report Iki, Yusuke Morofuji, Yoichi Kanamoto, Tadashi Horie, Nobutaka Izumo, Tsuyoshi Anda, Takeo Matsuo, Takayuki NMC Case Rep J Case Report Middle meningeal arteriovenous fistula (MMAVF) of a non-fractured site is extremely rare, and the clinical characteristics are still unclear. We report a case of delayed onset of venous infarction due to an MMAVF following a fall accident. A 69-year-old man sustained multiple trauma due to a fall accident. Head computed tomography (CT) showed traumatic subarachnoid hemorrhage, a left subdural hematoma, and skull fracture in his right temporal bone, all of which were managed conservatively. Five days after his admission, he suddenly exhibited total aphasia and right hemiparesis. Emergent CT revealed sporadic low-density areas in his left cerebral hemisphere, and four-dimensional CT angiography (4D-CTA) showed dilatation of the left middle meningeal artery and early venous drainage in the cavernous sinus and anterior temporal diploic vein (ATDV). A series of hemodynamics of 4D-CTA revealed early venous filling of ATDV interrelated with retrograde upward flow to high convexity in the venous phase. The MMAVF was successfully obliterated by transarterial coil embolization. We herein describe this case of MMAVF in which 4D-CTA was useful for the diagnosis. The Japan Neurosurgical Society 2020-03-24 /pmc/articles/PMC7162811/ /pubmed/32322452 http://dx.doi.org/10.2176/nmccrj.cr.2019-0185 Text en © 2020 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Case Report
Iki, Yusuke
Morofuji, Yoichi
Kanamoto, Tadashi
Horie, Nobutaka
Izumo, Tsuyoshi
Anda, Takeo
Matsuo, Takayuki
Traumatic Middle Meningeal Arteriovenous Fistula of Non-fractured Site Detected by Four-dimensional Computed Tomography Angiography: A Case Report
title Traumatic Middle Meningeal Arteriovenous Fistula of Non-fractured Site Detected by Four-dimensional Computed Tomography Angiography: A Case Report
title_full Traumatic Middle Meningeal Arteriovenous Fistula of Non-fractured Site Detected by Four-dimensional Computed Tomography Angiography: A Case Report
title_fullStr Traumatic Middle Meningeal Arteriovenous Fistula of Non-fractured Site Detected by Four-dimensional Computed Tomography Angiography: A Case Report
title_full_unstemmed Traumatic Middle Meningeal Arteriovenous Fistula of Non-fractured Site Detected by Four-dimensional Computed Tomography Angiography: A Case Report
title_short Traumatic Middle Meningeal Arteriovenous Fistula of Non-fractured Site Detected by Four-dimensional Computed Tomography Angiography: A Case Report
title_sort traumatic middle meningeal arteriovenous fistula of non-fractured site detected by four-dimensional computed tomography angiography: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162811/
https://www.ncbi.nlm.nih.gov/pubmed/32322452
http://dx.doi.org/10.2176/nmccrj.cr.2019-0185
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