Shigematsu Hideaki, Yokota Kazuma, Hirayama Akihiro, Sorimachi Takatoshi
Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
J Neuroendovasc Ther. 2023;17(3):88-92. doi: 10.5797/jnet.cr.2022-0058. Epub 2023 Feb 14.
A few cases of postsurgical iatrogenic arteriovenous shunts have been reported, with the arterial blood flow directly entering the pial veins. Herein, we reported a patient with a dural artery-pial vein shunt found 1 year after aneurysmal clipping.
A 64-year-old male presented with generalized convulsion 1 year after cerebral aneurysmal clipping. A CT showed intracerebral hemorrhage in the temporo-occipital cortex and a dural artery-pial vein shunt in proximity to the previous craniotomy center. The arterial blood flow from the deep temporal artery, the middle meningeal artery, and the anterior auricular branch of the superficial temporal artery shunted into the superficial middle cerebral vein, with evident cortical venous reflux. Embolization was performed with n-butyl-2-cyanoacrylate and completely occluded the shunt. The patient was discharged without neurological deficits.
Endovascular liquid embolization may be an effective treatment for iatrogenic dural artery-pial vein shunt.
已有少数术后医源性动静脉分流的病例报道，动脉血流直接进入软膜静脉。在此，我们报告1例在动脉瘤夹闭术后1年发现的硬脑膜动脉 - 软膜静脉分流患者。
一名64岁男性在脑动脉瘤夹闭术后1年出现全身性惊厥。CT显示颞枕叶皮质脑出血以及靠近先前开颅手术中心处存在硬脑膜动脉 - 软膜静脉分流。来自颞深动脉、脑膜中动脉和颞浅动脉前耳支的动脉血流分流至大脑中浅静脉，伴有明显的皮质静脉反流。使用正丁基 - 2 - 氰基丙烯酸酯进行栓塞，完全闭塞了分流。患者出院时无神经功能缺损。
血管内液体栓塞可能是治疗医源性硬脑膜动脉 - 软膜静脉分流的有效方法。
