雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

A case of dural AVM detected after STA-MCA anastomosis Keiji IGASE 1 , Yoshihisa OKA 1 , Yoshiaki KUMON 1 , Kiichiro ZENKE 1 , Shinji IWATA 1 , Saburo SAKAKI 1 1Department of Neurosurgery, Ehime University School of Medicine Keyword: dural AVM , STA-MCA anastomosis , embolization , congenital origin pp.81-85
Published Date 1996/1/10
DOI https://doi.org/10.11477/mf.1436901150
  • Abstract
  • Look Inside

A case of dural arteriovenous malformation (AVM) in the posterior cranial fossa detected after STA-MCA anastomosis surgery.

A 52-year-old male consulted a neighbourhood hos-pital for sudden headache and vomiting. He was dia-gnosed as having intraventricular hemorrhage on CT scan. Though the obstruction of the right internal caro-tid artery was revealed angiographically, his symptoms improved after conservative therapy. Two weeks after onset, his consciousness deteriorated and he developed left hemiparesis. Thereafter, he was transferred to our hospital. After thorough examination, right STA-MCA anastomosis surgery was performed. Approximately 2 months after surgery, right tinnitus developed and gra-dually exacerbated. Since it was thought to be due to increased blood flow in the right superficial temporal artery, it was kept under observation. On angiogram, 8 months after surgery, good blood flow supplied from the right superficial temporal artery to the territory of the right middle cerebral artery was shown, and a dural AVM fed by the right occipital artery was found.

Fourteen months after the surgery, an enlarged dural AVM with backflow to the superficial cerebral veins fed by the enlarged right occipital artery and right ascending pharyngeal artery was revealed. Emboliza-tion therapy to the right occipital and ascending pharyn-geal artery was performed using coils and ivalon, and irradiation of 30 Cry was added. After this treatment, right tinnitus improved. On angiography 2 years later, transverse sinus was slightly visible via the right occi-pital artery and ascending pharyngeal artery, but the dural AVM was significantly reduced.

The origin of dural AVMs remains controversial. In our case, dural AVM was not found before the STA-MCA anastomosis surgery, and sinus thrombosis was not found throughout the course of observation. It is thought that the occult dural AVM was disclosed and enlarged by the increased blood flow through the exter-nal carotid artery via the STA-MCA anastomosis. Therefore, the dural AVM seemed to be congenital in origin.


Copyright © 1996, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

関連文献

もっと見る

文献を共有