Zhou Liang-Fu, Chen Liang, Song Dong-Lei, Gu Yu-Xiang, Leng Bing
Department of Neurosurgery, Shanghai Neurosurgical Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
Neurosurg Rev. 2007 Jul;30(3):269-74; discussion 274. doi: 10.1007/s10143-007-0071-y. Epub 2007 May 5.
Dural arteriovenous fistula of the sphenobasilar sinus is a true but rare lesion that connects the meningeal arteries from both the external and internal carotid arteries to the superficial middle cerebral vein (SMCV) and dural sinus. It must be distinguished from other dural arteriovenous fistulas (DAVFs) of the middle cranial fossa, such as cavernous DAVFs and sphenoparietal sinus DAVF, because of differences in the treatment and outcome between these DAVFs. Two patients with sphenobasilar sinus DAVFs reported in the literature have been identified, but they did not simultaneously harbor intracranial meningiomas. To the best of the authors' knowledge, the patient described here is the first case that concomitantly harbors a sphenobasilar sinus DAVF and intracranial meningioma. A 42-year-old man presented with acute subarachnoid hemorrhage. Angiography demonstrated a DAVF of the sphenobasilar sinus with a giant venous aneurysm of the SMCV. After transarterial embolization, the fistula was successfully obliterated and the giant venous aneurysm was resected microsurgically. A fortuitous small meningioma at the anterior clinoid was found and removed during the operation. The patient recovered excellently and resumed his normal activities. The relevant literature is reviewed and discussed.
蝶骨基底窦硬脑膜动静脉瘘是一种确实存在但罕见的病变，它将来自颈外动脉和颈内动脉的脑膜动脉与大脑中浅静脉（SMCV）和硬脑膜窦相连。由于这些硬脑膜动静脉瘘在治疗和预后方面存在差异，因此必须将其与中颅窝的其他硬脑膜动静脉瘘（DAVF）区分开来，如海绵窦DAVF和蝶顶窦DAVF。文献中报道了两名患有蝶骨基底窦DAVF的患者，但他们并未同时患有颅内脑膜瘤。据作者所知，此处描述的患者是首例同时患有蝶骨基底窦DAVF和颅内脑膜瘤的病例。一名42岁男性因急性蛛网膜下腔出血就诊。血管造影显示蝶骨基底窦有一个DAVF，并伴有SMCV巨大静脉瘤。经动脉栓塞后，瘘口成功闭塞，巨大静脉瘤通过显微手术切除。术中偶然发现并切除了前床突处一个较小的脑膜瘤。患者恢复良好，恢复了正常活动。对相关文献进行了回顾和讨论。
