Department of Neurosurgery, Hôpital Lariboisière, Paris, Île-de-France, France; Department of Neurosurgery, Centre hospitalier de l'université de Montréal, Montréal, Québec, Canada.
Department of Neurosurgery, Hôpital Lariboisière, Paris, Île-de-France, France.
World Neurosurg. 2019 Dec;132:29-32. doi: 10.1016/j.wneu.2019.08.095. Epub 2019 Aug 23.
The use of nonadhesive liquid embolic agents (NALEAs) has gained great popularity in the treatment of brain vascular malformations, with a lower rate of local complications than surgery. However, we describe the formation of brain abscesses after endovascular treatment of a brain arteriovenous malformation (bAVM) and how important removal of the NALEAs was in the treatment of these abscesses.
A 68-year-old man presented with seizures after being treated for an unruptured bAVM using Squid (Emboflu), an NALEA. Radiologic imaging revealed brain lesions suspicious of abscesses around the previously treated bAVM. A surgical excision of the bAVM and the embolized material was performed as was drainage of the brain abscesses. Bacterial cultures were positive for Enterococcus faecalis, and the patient left the hospital with an appropriate antibiotic regimen without new deficits.
This is the first reported case of a bAVM treated with Squid complicated with brain abscesses, a rare but very serious complication. This complication should be treated not only using antibiotherapy but with complete safe removal of the embolic material.
非粘附性液体栓塞剂（NALEAs）在治疗脑血管畸形方面的应用越来越受欢迎，其局部并发症的发生率低于手术。然而，我们描述了在治疗脑动静脉畸形（bAVM）时使用血管内 NALEA 后形成脑脓肿的情况，以及清除 NALEAs 在治疗这些脓肿中的重要性。
一名 68 岁男性在接受 Squid（Emboflu）治疗未破裂的 bAVM 后出现癫痫发作，Squid 是一种 NALEA。影像学检查显示，之前治疗过的 bAVM 周围有脑病变，疑似脓肿。进行了 bAVM 和栓塞材料的手术切除，并对脑脓肿进行了引流。细菌培养结果为粪肠球菌阳性，患者在没有新的缺陷的情况下，接受了适当的抗生素治疗方案出院。
这是首例使用 Squid 治疗 bAVM 并发脑脓肿的病例报告，这是一种罕见但非常严重的并发症。这种并发症不仅需要使用抗生素治疗，还需要安全地完全清除栓塞材料。
