Paramasivam Srinivasan, Fifi Johanna T, Ortiz Rafael A, Niimi Yasunari, Berenstein Alejandro
Hyman Newman Institute for Neurology and Neurosurgery, Centre for Endovascular Surgery, Roosevelt Hospital, New York, NY 10019, USA.
J Neurosurg Pediatr. 2012 Mar;9(3):331-4. doi: 10.3171/2011.12.PEDS11396.
The authors present a rare case of arteriovenous fistula (AVF) of the basal vein of Rosenthal draining into a dilated vein of Galen managed by transarterial endovascular embolization. A male infant born at full term following a normal pregnancy and delivery with congestive heart failure, on investigation with MR imaging and MR angiography was found to have a basal vein of Rosenthal fistula with a dilated vein of Galen. His congestive heart failure was treated medically, and the AVF was managed electively at 10 months of age with successful transarterial endovascular embolization. The authors discuss the embryological aspects related to the pathological entity and the various clinical presentations, investigations, and management options. Management is primarily endovascular embolization; microsurgery is performed for a few selected cases, and radiosurgery has a limited role in older patients. Endovascular embolization is a safe and effective way to manage this malformation, with an excellent outcome if the AVF is eliminated by proper embolization at the fistulous point.
作者报告了一例罕见的经动脉血管内栓塞治疗的病例，即罗森塔尔基底静脉动静脉瘘（AVF）引流至扩张的大脑大静脉。一名足月顺产的男婴，患有充血性心力衰竭，经磁共振成像（MR）和磁共振血管造影（MRA）检查发现患有罗森塔尔基底静脉瘘合并大脑大静脉扩张。其充血性心力衰竭接受了药物治疗，该AVF在10个月大时接受了择期经动脉血管内栓塞治疗，治疗成功。作者讨论了与该病理实体相关的胚胎学方面以及各种临床表现、检查和治疗选择。治疗主要采用血管内栓塞；少数特定病例采用显微手术，放射外科在老年患者中的作用有限。血管内栓塞是治疗这种畸形的一种安全有效的方法，如果在瘘口处通过适当栓塞消除AVF，则预后良好。
