Department of Neurosurgery, Kyoto Daini Red Cross Hospital, Kyoto, Japan.
Br J Neurosurg. 2023 Aug;37(4):604-607. doi: 10.1080/02688697.2019.1648755. Epub 2019 Jul 31.
N-butyl cyanoacrylate (NBCA) has been used to embolise brain arteriovenous malformations (AVMs) for over 30 years. It is a mixed with lipiodol in varying proportions. We report a 22-year-old male with intraventricular hemorrhage from a ruptured intranidal AVM aneurysm in the left temporal lobe. The intranidal aneurysm and the nidus were successfully embolized using a 20% NBCA and lipiodol mixture without any complications according to computed tomography (CT) immediately after treatment. Scattered high-density spots were observed in both lateral ventricles on CT 5 days after embolization, suggesting migration of lipiodol. We speculated that the aneurysm was a pseudoaneurysm whose wall protruded into the inferior horn of the left lateral ventricle, and the lipiodol in the NBCA migrated into the ventricles after the thin part of the wall ruptured. The patient developed pyrexia due to chemical meningitis, which responded to steroid treatment for one month.
正丁基氰基丙烯酸酯 (NBCA) 已被用于栓塞脑动静脉畸形 (AVM) 超过 30 年。它与碘油以不同比例混合。我们报告了一名 22 岁男性，因左颞叶颅内 AVM 动脉瘤破裂导致脑室出血。根据治疗后即刻的计算机断层扫描 (CT)，使用 20% NBCA 和碘油混合物成功栓塞了颅内动脉瘤和病灶，没有任何并发症。栓塞后 5 天，CT 显示两侧侧脑室均可见散在高密度点，提示碘油迁移。我们推测该动脉瘤是假性动脉瘤，其壁向左侧侧脑室下角突出，薄壁破裂后 NBCA 中的碘油进入脑室。患者因化学性脑膜炎发热，经皮质类固醇治疗一个月后缓解。
