Machida T, Hayashi N, Sasaki Y, Aoki S, Shirouzu I, Sasaki Y, Inoue K, Maehara T
Department of Radiology, University of Tokyo, Japan.
Neuroradiology. 1993;35(3):210-1. doi: 10.1007/BF00588496.
Dural arteriovenous malformations (AVMs) in the posterior cranial fossa are relatively infrequent. Intradural haemorrhage is one of their specific complications. Angiographic demonstration of varices or aneurysmal structures is one of the hallmarks of severe cases. We report a patient with posterior cranial fossa dural AVM associated with a varix mimicking a thrombosed aneurysm on CT and MRI. Internal carotid and vertebral angiography failed to demonstrate an aneurysm, but external carotid injection revealed a dural AVM affecting the sigmoid sinus, and a varix. The AVM was completely eliminated by embolization. When a dural AVM is suspected clinically selective angiography should be performed to confirm the diagnosis even when CT or MRI do not show dilated vessels.
后颅窝硬脑膜动静脉畸形(AVM)相对少见。硬脑膜内出血是其特定并发症之一。静脉曲张或动脉瘤样结构的血管造影显示是严重病例的特征之一。我们报告一例后颅窝硬脑膜AVM患者,其伴有一个在CT和MRI上酷似血栓形成动脉瘤的静脉曲张。颈内动脉和椎动脉血管造影未能显示动脉瘤,但颈外动脉注射造影显示一个累及乙状窦的硬脑膜AVM和一个静脉曲张。该AVM通过栓塞得以完全消除。当临床上怀疑硬脑膜AVM时,即使CT或MRI未显示血管扩张,也应进行选择性血管造影以确诊。