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Microsurgical treatment of lateral cavernous sinus wall dural arteriovenous fistula with large venous aneurysm: A case report

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 sc...

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Autores principales: Kim, Dong Jin, Park, Wonhyoung, Park, Jung Cheol, Ahn, Jae Sung, Lee, Deok Hee, Byun, Joonho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041508/
https://www.ncbi.nlm.nih.gov/pubmed/33017880
http://dx.doi.org/10.7461/jcen.2020.E2020.08.001
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author Kim, Dong Jin
Park, Wonhyoung
Park, Jung Cheol
Ahn, Jae Sung
Lee, Deok Hee
Byun, Joonho
author_facet Kim, Dong Jin
Park, Wonhyoung
Park, Jung Cheol
Ahn, Jae Sung
Lee, Deok Hee
Byun, Joonho
author_sort Kim, Dong Jin
collection PubMed
description 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.
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spelling pubmed-80415082021-04-19 Microsurgical treatment of lateral cavernous sinus wall dural arteriovenous fistula with large venous aneurysm: A case report Kim, Dong Jin Park, Wonhyoung Park, Jung Cheol Ahn, Jae Sung Lee, Deok Hee Byun, Joonho J Cerebrovasc Endovasc Neurosurg Case Report 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. Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 2021-03 2020-10-06 /pmc/articles/PMC8041508/ /pubmed/33017880 http://dx.doi.org/10.7461/jcen.2020.E2020.08.001 Text en Copyright © 2021 by KSCVS and KoNES https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kim, Dong Jin
Park, Wonhyoung
Park, Jung Cheol
Ahn, Jae Sung
Lee, Deok Hee
Byun, Joonho
Microsurgical treatment of lateral cavernous sinus wall dural arteriovenous fistula with large venous aneurysm: A case report
title Microsurgical treatment of lateral cavernous sinus wall dural arteriovenous fistula with large venous aneurysm: A case report
title_full Microsurgical treatment of lateral cavernous sinus wall dural arteriovenous fistula with large venous aneurysm: A case report
title_fullStr Microsurgical treatment of lateral cavernous sinus wall dural arteriovenous fistula with large venous aneurysm: A case report
title_full_unstemmed Microsurgical treatment of lateral cavernous sinus wall dural arteriovenous fistula with large venous aneurysm: A case report
title_short Microsurgical treatment of lateral cavernous sinus wall dural arteriovenous fistula with large venous aneurysm: A case report
title_sort microsurgical treatment of lateral cavernous sinus wall dural arteriovenous fistula with large venous aneurysm: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041508/
https://www.ncbi.nlm.nih.gov/pubmed/33017880
http://dx.doi.org/10.7461/jcen.2020.E2020.08.001
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