Yajima Hirohisa, Miyawaki Satoru, Koizumi Satoshi, Kiyofuji Satoshi, Hongo Hiroki, Segawa Masafumi, Kin Taichi, Nakatomi Hirofumi, Saito Nobuhito
1Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
2Department of Medical Information Engineering, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; and.
J Neurosurg Case Lessons. 2022 Aug 1;4(5). doi: 10.3171/CASE22253.
The precise etiology of dural arteriovenous fistula (DAVF) is still unknown. The authors reported a case of delayed postoperative sigmoid sinus (SS) DAVF secondary to SS thrombosis after resection of a foramen magnum meningioma through a suboccipital craniotomy.
The authors visualized the clear architecture of the DAVF using fusion three-dimensional computer graphics (3DCG) images reconstructed from multimodal imaging studies. These fusion 3DCG images revealed that the feeders of the DAVF had connected through neovascularization to the SS at the previous thrombus site. The authors also reviewed previously reported cases of DAVFs that developed after craniotomy.
This study indicated that SS stenosis and occlusion with sinus thrombosis are possible risk factors for delayed postoperative DAVF that demand special consideration.
硬脑膜动静脉瘘(DAVF)的确切病因仍不清楚。作者报告了1例经枕下开颅切除枕骨大孔脑膜瘤后,因乙状窦(SS)血栓形成继发迟发性术后SS DAVF的病例。
作者使用从多模态成像研究重建的融合三维计算机图形(3DCG)图像可视化了DAVF的清晰结构。这些融合3DCG图像显示,DAVF的供血动脉通过新生血管形成与先前血栓部位的SS相连。作者还回顾了先前报道的开颅术后发生DAVF的病例。
本研究表明,SS狭窄和伴有窦血栓形成的闭塞可能是术后迟发性DAVF的危险因素,需要特别考虑。