Kawahara Ichiro, Fujimoto Takashi, Hirose Makoto, Toyoda Keisuke, Kitagawa Naoki
Department of Neurosurgery, Nagasaki Rosai Hospital.
No Shinkei Geka. 2017 Jun;45(6):519-526. doi: 10.11477/mf.1436203542.
Dural arteriovenous fistula(dAVF)is relatively rare, and its etiology remains uncertain. Generally, dAVF is thought to be acquired and has been reported to develop secondary to sinus thrombosis, head injury, infection, and surgery. We report a rare case of dAVF in the anterior cranial fossa that developed remote from the craniotomy site after surgery. A 52-year-old man underwent surgery for hypertensive intracerebral hemorrhage 4 years prior. Perioperative imaging modalities demonstrated no abnormal vascular malformation except for an un-ruptured anterior communicating artery aneurysm. Four years later, follow-up magnetic resonance angiography showed abnormal vascular malformation in the anterior cranial fossa, and cerebral angiography demonstrated dAVF. dAVF and aneurysm were successfully treated. Possible formation of a dAVF should be considered after craniotomy.
硬脑膜动静脉瘘（dAVF）相对少见，其病因尚不确定。一般认为dAVF是后天获得性的，据报道可继发于静脉窦血栓形成、头部损伤、感染及手术。我们报告1例罕见的前颅窝dAVF病例，其在手术后远离开颅部位形成。1名52岁男性4年前因高血压脑出血接受手术。围手术期影像学检查未发现除未破裂的前交通动脉瘤外的异常血管畸形。4年后，随访磁共振血管造影显示前颅窝有异常血管畸形，脑血管造影证实为dAVF。dAVF和动脉瘤均得到成功治疗。开颅术后应考虑dAVF形成的可能性。
