Mixed pial and dural arteriovenous fistula after craniotomy : case report and literature review
Dural arteriovenous fistula (AVF) is known to occur after craniotomy, but mixed pial and dural AVF after craniotomy has not been reported. A 45-year-old man who had undergone surgical clipping of an unruptured aneurysm 2 years previously presented with small subcortical hemorrhage from mixed pial and dural AVF. Surgical disconnection could not be cured completely due to the granulomatous tissue around the aneurysm, and the presence of an undetected shunt. Postoperative digital subtraction angiography showed a new pial AVF supplied by the middle cerebral artery pial branches. Many branches were associated with the remnant aneurysm and pial AVF, so we did not try to embolize the fistula. Gamma knife surgery was performed as adjuvant radiotherapy, which achieved angiographically complete occlusion of the shunt points. Multimodal approaches including surgery, endovascular intervention, and radiotherapy are needed for radiological and clinical cure of mixed pial and dural AVF. Long-term follow up is essential.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
British journal of neurosurgery - 37(2023), 4 vom: 09. Aug., Seite 836-839 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Doi, Kazuma [VerfasserIn] |
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| Links: |
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| Themen: |
Case Reports |
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| Anmerkungen: |
Date Completed 07.07.2023 Date Revised 18.07.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/02688697.2019.1672860 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM302044485 |
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| 520 | |a Dural arteriovenous fistula (AVF) is known to occur after craniotomy, but mixed pial and dural AVF after craniotomy has not been reported. A 45-year-old man who had undergone surgical clipping of an unruptured aneurysm 2 years previously presented with small subcortical hemorrhage from mixed pial and dural AVF. Surgical disconnection could not be cured completely due to the granulomatous tissue around the aneurysm, and the presence of an undetected shunt. Postoperative digital subtraction angiography showed a new pial AVF supplied by the middle cerebral artery pial branches. Many branches were associated with the remnant aneurysm and pial AVF, so we did not try to embolize the fistula. Gamma knife surgery was performed as adjuvant radiotherapy, which achieved angiographically complete occlusion of the shunt points. Multimodal approaches including surgery, endovascular intervention, and radiotherapy are needed for radiological and clinical cure of mixed pial and dural AVF. Long-term follow up is essential | ||
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| 650 | 4 | |a endovascular intervention | |
| 650 | 4 | |a gamma knife surgery | |
| 650 | 4 | |a pial arteriovenous fistula | |
| 650 | 4 | |a radiosurgery | |
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| 700 | 1 | |a Hayashi, Motohiro |e verfasserin |4 aut | |
| 700 | 1 | |a Takeuchi, Satoru |e verfasserin |4 aut | |
| 700 | 1 | |a Toyooka, Terushige |e verfasserin |4 aut | |
| 700 | 1 | |a Wada, Kojiro |e verfasserin |4 aut | |
| 700 | 1 | |a Mori, Kentaro |e verfasserin |4 aut | |
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