Laviv Yosef, Kasper Ekkehard, Perlow Eliyahu
Departments of Surgery, Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
Department of Radiology, Rabin Medical Center, Beilinson Hospital, Tel-Aviv University, Petah-Tiqva, Israel.
Acta Neurochir (Wien). 2016 Feb;158(2):255-9. doi: 10.1007/s00701-015-2676-1. Epub 2015 Dec 30.
Galenic dural arteriovenous fistula (DAVF) represents a unique, hard to treat subgroup of tentorial DAVFs. We present an unusual case of hemorrhagic Galenic DAVF in a 54-year-old woman. The fistula drained directly to the vein of Galen through multiple feeders. Complete occlusion of the fistula was achieved through transarterial embolization. Deep venous drainage remained intact and the patient recovered well. To our knowledge, this is the first report on complete closure of hemorrhagic Galenic DAVF using transarterial embolization with complete obliteration of vein of Galen. The presence of nonfunctioning straight sinus may have contributed to the success of treatment and it may be considered as a predictive marker for endovascular embolization.
盖伦静脉型硬脑膜动静脉瘘(DAVF)是天幕区DAVF中一种独特且难以治疗的亚型。我们报告了一例54岁女性出血性盖伦静脉型DAVF的罕见病例。该瘘通过多个供血支直接引流至大脑大静脉。通过经动脉栓塞实现了瘘的完全闭塞。深部静脉引流保持完整,患者恢复良好。据我们所知,这是首例使用经动脉栓塞完全封闭出血性盖伦静脉型DAVF并使大脑大静脉完全闭塞的报告。无功能的直窦的存在可能促成了治疗的成功,它可被视为血管内栓塞的一个预测指标。