van Rooij Willem Jan, Sluzewski Menno, Beute Guus N
Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, The Netherlands.
Neuroradiology. 2006 Oct;48(10):737-43. doi: 10.1007/s00234-006-0118-8. Epub 2006 Aug 4.
The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles.
Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas.
All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe.
Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas.
小脑幕动脉常参与小脑幕硬脑膜动静脉瘘的供血。肥大的小脑幕动脉可进行栓塞,可使用胶水或颗粒。
报告6例小脑幕硬脑膜动静脉瘘患者,主要由小脑幕动脉供血。2例患者出现颅内出血,2例出现搏动性耳鸣,1例出现进行性四肢轻瘫,1例患者的小脑幕硬脑膜动静脉瘘为偶然发现。在瘘管的血管内闭塞过程中,采用了不同的血管内技术栓塞小脑幕动脉。
所有6例小脑幕硬脑膜动静脉瘘均通过血管内技术完全闭塞,随访血管造影证实。无并发症发生。当能够直接插管至小脑幕动脉时,在小脑幕动脉起源水平用临时球囊闭塞颈内动脉后注射胶水是有效且安全的。
不同的血管内技术可成功应用于栓塞小脑幕动脉以治疗小脑幕硬脑膜动静脉瘘。