Mondel Prabath Kumar, Saraf Rashmi, Limaye Uday S
Interventional Neuroradiology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India.
BMJ Case Rep. 2014 Jul 2;2014:bcr2014011273. doi: 10.1136/bcr-2014-011273.
A 43-year-old man presented with acute subarachnoid hemorrhage. He was investigated and found to have a rare posterior condylar canal dural arteriovenous fistula (DAVF). DAVFs of the posterior condylar canal are rare. Venous drainage of the DAVF was through a long, tortuous, and aneurysmal bridging vein. We describe the clinical presentation, cross sectional imaging, angiographic features, and endovascular management of this patient. The patient was treated by transarterial embolization of the fistula through the ascending pharyngeal artery. This is the first report of an acutely bled posterior condylar canal DAVF treated by transarterial Onyx embolization with balloon protection in the vertebral artery. The patient recovered without any neurological deficit and had an excellent outcome. On 6 month follow-up angiogram, there was stable occlusion of the dural fistula.
一名43岁男性因急性蛛网膜下腔出血就诊。经检查发现他患有罕见的后髁管硬脑膜动静脉瘘（DAVF）。后髁管的DAVF很罕见。该DAVF的静脉引流通过一条长而迂曲且呈瘤样的桥静脉。我们描述了该患者的临床表现、横断面成像、血管造影特征及血管内治疗情况。患者通过经咽升动脉对瘘口进行经动脉栓塞治疗。这是首例经动脉使用Onyx栓塞并在椎动脉内使用球囊保护治疗急性出血性后髁管DAVF的报告。患者康复且无任何神经功能缺损，预后良好。在6个月的随访血管造影中，硬脑膜瘘口闭塞稳定。
