Yoshida Hidenori, Kaneko Yoshirou, Ooasa Takao, Ogasawara Sadanobu, Uozumi Youichi, Kawano Teruaki, Kawaguchi Tsutomu
Department of Neurosurgery, Fukuoka Tokushukai Hospital, 4-5 Suku-kita, Kasuga-city, Fukuoka 816-0864, Japan.
No Shinkei Geka. 2003 Jun;31(6):657-61.
We reported a case of bleeding from the varix of a transverse-sigmoid sinus dural arteriovenous fistula with pure leptomeningeal drainage. A 55-year-old man presented with visual disturbance. neurological examination revealed left homonymous hemianopsia. CT scans demonstrated a subcortical hemorrhage in the right occipital lobe. Right external carotid angiograms showed a dural arteriovenous fistula of the transverse-sigmoid sinus fed by middle meningeal arteries and the occipital artery. The draining vein was the cortical vein with a varix. Transverse and sigmoid sinuses were patent. We concluded that the cause of the subcortical hemorrhage was a varix of the dural arteriovenous fistula. Initially, we embolized the dural arteriovenous fistula using a transarterial approach with GDC. Additionally, we interrupted the draining vein of the dural arteriovenous malformation. Angiographic cure was obtained and the postoperative course was uneventful. We discussed the clinical features, and the management of this case.
我们报告了一例横窦-乙状窦窦硬膜动静脉瘘伴单纯软脑膜引流静脉瘤出血的病例。一名55岁男性因视力障碍就诊。神经系统检查发现左侧同向性偏盲。CT扫描显示右侧枕叶皮质下出血。右侧颈外动脉血管造影显示横窦-乙状窦窦硬膜动静脉瘘，由脑膜中动脉和枕动脉供血。引流静脉为伴有静脉瘤的皮质静脉。横窦和乙状窦通畅。我们得出结论，皮质下出血的原因是硬膜动静脉瘘的静脉瘤。最初，我们采用经动脉途径使用GDC栓塞硬膜动静脉瘘。此外，我们阻断了硬膜动静脉畸形的引流静脉。获得了血管造影治愈，术后过程顺利。我们讨论了该病例的临床特征及治疗。
