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联合开颅手术和血管内栓塞治疗破裂的蝶骨翼硬脑膜动静脉瘘。

Combined open surgery and endovascular embolization for a ruptured sphenoid wing dural arteriovenous fistula.

机构信息

Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Thammasat University Hospital, Pathum Thani, 12120, Thailand.

出版信息

Acta Neurochir (Wien). 2024 Aug 12;166(1):333. doi: 10.1007/s00701-024-06226-4.

DOI:10.1007/s00701-024-06226-4
PMID:39133314
Abstract

BACKGROUND

The sphenoid wing dural arteriovenous fistula (AVF) is rare, and can manifest with severe symptoms, particularly in cases classified as greater sphenoid wing type. Endovascular therapy is generally employed, however, open surgical intervention could be warranted in cases with complex fistula.

METHOD

We present a case with ruptured greater sphenoid wing dural AVF (Cognard type IV), in which endovascular embolization using liquid material was performed, followed by open surgery to concurrently disconnect the fistula and evacuate the hematoma.

CONCLUSION

The sphenoid wing dural AVFs may be effectively cured by open surgery for fistula disconnection in conjunction with endovascular embolization.

摘要

背景

蝶骨翼部硬脑膜动静脉瘘(AVF)较为罕见,可表现出严重的症状,尤其是在被归类为更大蝶骨翼部类型的病例中。通常采用血管内治疗,但对于具有复杂瘘的病例,可能需要进行开放性手术干预。

方法

我们报告了一例破裂的更大蝶骨翼部硬脑膜动静脉瘘(Cognard 四型)病例,采用液体材料进行了血管内栓塞,随后进行开放性手术同时断开瘘管并清除血肿。

结论

通过开放性手术断开瘘管并结合血管内栓塞,可有效治愈蝶骨翼部硬脑膜动静脉瘘。

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本文引用的文献

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Direct superior sagittal sinus puncture via a surgical burr hole for curative embolization of the complex transverse-sigmoid sinus dural arteriovenous fistula: How I do it.经手术磨钻直接穿刺正中矢状窦治疗复杂横窦-乙状窦硬脑膜动静脉瘘的栓塞治疗:我的经验分享。
Acta Neurochir (Wien). 2024 Mar 12;166(1):131. doi: 10.1007/s00701-024-06020-2.
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Non-Sinus-Type Laterocavernous Sinus Dural Arteriovenous Fistula Treated by Transarterial Venous Coil Embolization: A Case Report.经动脉静脉弹簧圈栓塞治疗非窦型外侧海绵窦硬脑膜动静脉瘘:一例报告
J Neuroendovasc Ther. 2022;16(4):225-231. doi: 10.5797/jnet.cr.2021-0021. Epub 2021 Sep 3.
3
Sphenoid dural arteriovenous fistulas.
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Neurosurg Rev. 2021 Feb;44(1):77-96. doi: 10.1007/s10143-019-01209-x. Epub 2019 Dec 7.
4
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J Stroke Cerebrovasc Dis. 2014 Jul;23(6):1730-5. doi: 10.1016/j.jstrokecerebrovasdis.2013.12.037. Epub 2014 Feb 28.
5
Middle cranial fossa sphenoidal region dural arteriovenous fistulas: anatomic and treatment considerations.中颅窝蝶骨区硬脑膜动静脉瘘:解剖和治疗考虑。
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