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Intracranial varix of the transverse-sigmoid dural arteriovenous fistula mimicking a ruptured middle cerebral artery aneurysm: A case report

BACKGROUND: Hemorrhagic stroke is caused by various vascular abnormalities, such as aneurysms, arteriovenous malformations, and dural arteriovenous fistulas (DAVF). Magnetic resonance angiography (MRA) and three-dimensional computed tomography angiography (3DCTA) are used as efficient initial diagno...

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Autores principales: Onuma, Kuniyuki, Yanaka, Kiyoyuki, Tsukada, Atsushi, Nakamura, Kazuhiro, Matsumaru, Yuji, Ishikawa, Eiichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8986638/
https://www.ncbi.nlm.nih.gov/pubmed/35399877
http://dx.doi.org/10.25259/SNI_79_2022
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author Onuma, Kuniyuki
Yanaka, Kiyoyuki
Tsukada, Atsushi
Nakamura, Kazuhiro
Matsumaru, Yuji
Ishikawa, Eiichi
author_facet Onuma, Kuniyuki
Yanaka, Kiyoyuki
Tsukada, Atsushi
Nakamura, Kazuhiro
Matsumaru, Yuji
Ishikawa, Eiichi
author_sort Onuma, Kuniyuki
collection PubMed
description BACKGROUND: Hemorrhagic stroke is caused by various vascular abnormalities, such as aneurysms, arteriovenous malformations, and dural arteriovenous fistulas (DAVF). Magnetic resonance angiography (MRA) and three-dimensional computed tomography angiography (3DCTA) are used as efficient initial diagnostic modalities in assessing the etiology of hemorrhagic stroke. We describe the unusual case of a false-positive aneurysm on MRA and 3DCTA. CASE DESCRIPTION: A 65-year-old nonhypertensive woman was brought to our hospital with a sudden onset of headache and left hemiparesis. She also had chemosis in the right eye. CT and magnetic resonance imaging showed an intracerebral hemorrhage in the right temporal lobe. MRA and 3DCTA showed a rounded mass suggestive of an aneurysm arising from the bifurcation of the middle cerebral artery (MCA) and also demonstrated an abnormal tortuous vessel contacting with a rounded mass. Digital subtraction angiography showed a transversesigmoid sinus DAVF with a varix in contact with the MCA bifurcation. Hematoma evacuation and venous drainage disconnection through the right frontotemporal craniotomy were performed. CONCLUSION: This case is very instructive and clinicians should keep in mind that detailed neurological and radiological examinations are essential in obtaining an accurate diagnosis, especially if the bleeding source is similar in shape and location to common lesions (such as a cerebral aneurysm).
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spelling pubmed-89866382022-04-07 Intracranial varix of the transverse-sigmoid dural arteriovenous fistula mimicking a ruptured middle cerebral artery aneurysm: A case report Onuma, Kuniyuki Yanaka, Kiyoyuki Tsukada, Atsushi Nakamura, Kazuhiro Matsumaru, Yuji Ishikawa, Eiichi Surg Neurol Int Case Report BACKGROUND: Hemorrhagic stroke is caused by various vascular abnormalities, such as aneurysms, arteriovenous malformations, and dural arteriovenous fistulas (DAVF). Magnetic resonance angiography (MRA) and three-dimensional computed tomography angiography (3DCTA) are used as efficient initial diagnostic modalities in assessing the etiology of hemorrhagic stroke. We describe the unusual case of a false-positive aneurysm on MRA and 3DCTA. CASE DESCRIPTION: A 65-year-old nonhypertensive woman was brought to our hospital with a sudden onset of headache and left hemiparesis. She also had chemosis in the right eye. CT and magnetic resonance imaging showed an intracerebral hemorrhage in the right temporal lobe. MRA and 3DCTA showed a rounded mass suggestive of an aneurysm arising from the bifurcation of the middle cerebral artery (MCA) and also demonstrated an abnormal tortuous vessel contacting with a rounded mass. Digital subtraction angiography showed a transversesigmoid sinus DAVF with a varix in contact with the MCA bifurcation. Hematoma evacuation and venous drainage disconnection through the right frontotemporal craniotomy were performed. CONCLUSION: This case is very instructive and clinicians should keep in mind that detailed neurological and radiological examinations are essential in obtaining an accurate diagnosis, especially if the bleeding source is similar in shape and location to common lesions (such as a cerebral aneurysm). Scientific Scholar 2022-03-25 /pmc/articles/PMC8986638/ /pubmed/35399877 http://dx.doi.org/10.25259/SNI_79_2022 Text en Copyright: © 2022 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Onuma, Kuniyuki
Yanaka, Kiyoyuki
Tsukada, Atsushi
Nakamura, Kazuhiro
Matsumaru, Yuji
Ishikawa, Eiichi
Intracranial varix of the transverse-sigmoid dural arteriovenous fistula mimicking a ruptured middle cerebral artery aneurysm: A case report
title Intracranial varix of the transverse-sigmoid dural arteriovenous fistula mimicking a ruptured middle cerebral artery aneurysm: A case report
title_full Intracranial varix of the transverse-sigmoid dural arteriovenous fistula mimicking a ruptured middle cerebral artery aneurysm: A case report
title_fullStr Intracranial varix of the transverse-sigmoid dural arteriovenous fistula mimicking a ruptured middle cerebral artery aneurysm: A case report
title_full_unstemmed Intracranial varix of the transverse-sigmoid dural arteriovenous fistula mimicking a ruptured middle cerebral artery aneurysm: A case report
title_short Intracranial varix of the transverse-sigmoid dural arteriovenous fistula mimicking a ruptured middle cerebral artery aneurysm: A case report
title_sort intracranial varix of the transverse-sigmoid dural arteriovenous fistula mimicking a ruptured middle cerebral artery aneurysm: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8986638/
https://www.ncbi.nlm.nih.gov/pubmed/35399877
http://dx.doi.org/10.25259/SNI_79_2022
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