Harada J, Okamoto S, Hamada H, Kubo M, Kuwayama N, Endo S
Department of Neurosurgery, Saiseikai Takaoka Hospital, 387-1 Futazuka, Takaoka-city, Toyama 933-0816, Japan.
No Shinkei Geka. 2001 May;29(5):421-5.
We reported a case with dural arteriovenous fistula (dAVF) of the anterior cranial fossa associated with occlusion of the left cervical internal carotid artery. A 73-year-old man was admitted with total aphasia and right hemiparesis. Computed tomography showed an ischemic lesion of the left cerebral hemisphere and old infarction of the left occipital lobe. Angiography revealed occlusion of the left cervical internal carotid artery and dAVF of the anterior cranial fossa, fed by the left middle meningeal and the right anterior ethmoidal artery. Follow-up angiography revealed spontaneous recanalization and severe arteriosclerosis of the left internal carotid artery. After marked improvement of neurological deficits, the patient underwent surgical clipping of the draining veins to occlude the dAVF of the anterior cranial fossa. We speculated that marked development of the collateral circulation from the external carotid system might result in the occurrence of dAVF of the anterior cranial fossa.
我们报告了一例前颅窝硬脑膜动静脉瘘（dAVF）合并左侧颈内动脉闭塞的病例。一名73岁男性因完全性失语和右侧偏瘫入院。计算机断层扫描显示左侧大脑半球有缺血性病变以及左侧枕叶陈旧性梗死。血管造影显示左侧颈内动脉闭塞以及前颅窝dAVF，由左侧脑膜中动脉和右侧筛前动脉供血。随访血管造影显示左侧颈内动脉自发再通及严重动脉硬化。神经功能缺损明显改善后，患者接受了引流静脉的手术夹闭以闭塞前颅窝的dAVF。我们推测来自颈外动脉系统的侧支循环显著发育可能导致前颅窝dAVF的发生。
