Zhang Chang Wei, Fu Wei, Richard Seidu A, Xie Xiao Dong
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Medicine, Princefield University, Ghana, West Africa.
Medicine (Baltimore). 2019 Apr;98(14):e15026. doi: 10.1097/MD.0000000000015026.
Dural arteriovenous fistulae (DAVF) are vascular disorders depicted with direct interconnection between dural arteries and cerebral venous sinuses and/or cortical veins. Only a hand full of cases have been reported in literature. DAVF obstructing the 3rd ventricle and quadrigeminal cistern resulting in hydrocephalus is very rare.
We present a 55-year-old female with 2 years history of headaches and blurring of vision. Cranial nerves examinations were unremarkable.
Magnetic Resonance Imaging (MRI) and digital subtraction angiography showed multiple tortuous vascular malformation in the 3rd ventricle and quadrigeminal cistern resulting in obstructive hydrocephalus (OHC).
We utilized endovascular embolization treatment option to obliterate the lesion. We used Onyx embolization agent (ev3 Neurovascular, Irvine, CA) to embolize the lesion via the transarterial route.
The OHC resolved spontaneously after the endovascular embolization of the DAVF. The patient recovered with no further neurologic complication. Two years follow-up reveal no recurrence of the DAVF as well as hydrocephalus.
Adequate knowledge on the vascular anatomy is very crucial in managing DAVF.
硬脑膜动静脉瘘（DAVF）是一种血管疾病，其特征为硬脑膜动脉与脑静脉窦和/或皮质静脉之间存在直接连接。文献中仅报道了少数病例。DAVF阻塞第三脑室和四叠体池导致脑积水的情况极为罕见。
我们报告一名55岁女性，有2年头痛和视力模糊病史。颅神经检查无异常。
磁共振成像（MRI）和数字减影血管造影显示第三脑室和四叠体池存在多个迂曲的血管畸形，导致梗阻性脑积水（OHC）。
我们采用血管内栓塞治疗方案来闭塞病变。我们使用Onyx栓塞剂（ev3 Neurovascular，加利福尼亚州欧文市）经动脉途径栓塞病变。
DAVF血管内栓塞后，OHC自行缓解。患者康复且无进一步神经并发症。两年随访显示DAVF及脑积水均未复发。
在处理DAVF时，对血管解剖结构有充分的了解非常关键。
