Saito Atsushi, Kawaguchi Tomohiro, Sasaki Tatsuya, Nishijima Michiharu
Department of Neurosurgery, Aomori Prefectural Central Hospital, Aomori, Japan.
Case Rep Neurol. 2014 Apr 30;6(1):122-5. doi: 10.1159/000362116. eCollection 2014 Jan.
Dural arteriovenous fistula (AVF) presenting with subdural hematoma is relatively rare. We report a case of dural AVF presenting as acute subdural hematoma (ASDH) and provide a review of the literature. A 56-year-old man presented with disturbance of consciousness. Computed tomography demonstrated a right ASDH and a small right occipital subcortical hematoma. Cerebral angiography showed a dural AVF on the occipital convexity draining into the cortical veins. Emergent endovascular embolization was immediately performed and the shunt flow disappeared. Hematoma removal and external decompression were safely conducted. Combined therapy successfully recovered the patient's consciousness level. This rare case of dural AVF presenting with ASDH was treated with combined treatments of endovascular and open surgery.
表现为硬膜下血肿的硬脑膜动静脉瘘(AVF)相对罕见。我们报告一例表现为急性硬膜下血肿(ASDH)的硬脑膜AVF病例,并对文献进行综述。一名56岁男性出现意识障碍。计算机断层扫描显示右侧ASDH和右侧枕叶皮质下小血肿。脑血管造影显示枕叶凸面有一个硬脑膜AVF,引流至皮质静脉。立即进行了急诊血管内栓塞,分流血流消失。安全地进行了血肿清除和外部减压。联合治疗成功恢复了患者的意识水平。这例罕见的表现为ASDH的硬脑膜AVF病例采用血管内和开放手术联合治疗。