Wajima Daisuke, Kamide Tomoya, Sasagawa Yasuo, Takata Sho, Misaki Kouichi, Nakada Mitsutoshi
Department of Neurosurgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, 9208641, Ishikawa, Japan.
Acta Neurochir (Wien). 2025 Jan 11;167(1):10. doi: 10.1007/s00701-024-06418-y.
A 54-year-old man presented with gait disturbances, urinary incontinence, and headache for 6 months. Head computed tomography indicated several high-density mass lesions in the quadrigeminal cistern, causing occlusive hydrocephalus. Digital subtraction angiography confirmed tentorial dural arteriovenous fistulae (AVF). Transarterial embolization (TAE) achieved complete angiographic resolution. However, acute occlusive hydrocephalus worsened, necessitating endoscopic third ventriculostomy (ETV). The patient was discharged without new symptoms and no hydrocephalus recurrence at six-month follow-up. Hydrocephalus is rare in patients with dural AVF and mostly resolves spontaneously after treatment; however, if thrombosis and enlargement of the varix occur after treatment, acute occlusive hydrocephalus can develop.
一名54岁男性出现步态障碍、尿失禁和头痛6个月。头部计算机断层扫描显示四叠体池有多个高密度肿块病变，导致梗阻性脑积水。数字减影血管造影证实为天幕硬脑膜动静脉瘘（AVF）。经动脉栓塞术（TAE）实现了血管造影完全消退。然而，急性梗阻性脑积水恶化，需要进行内镜下第三脑室造瘘术（ETV）。患者出院时无新症状，六个月随访时无脑积水复发。硬脑膜AVF患者中脑积水罕见，大多数在治疗后可自发缓解；然而，如果治疗后发生血栓形成和静脉曲张扩大，则可能发展为急性梗阻性脑积水。
