Ozawa T, Miyasaka Y, Tanaka R, Kurata A, Fujii K
Department of Neurosurgery, Kitasato University School of Medicine, Kanagawa, Japan.
Stroke. 1998 Aug;29(8):1721-4. doi: 10.1161/01.str.29.8.1721.
We report an unusual case of acquired dural-pial arteriovenous malformation (AVM) following sinus thrombosis.
Initial angiography performed in a 39-year-old man showed thrombosis of the superior sagittal sinus (SSS) and the right transverse sinus (TS) but no vascular malformations. Follow-up angiography 29 months later revealed recanalization of the SSS and the TS, retrograde cortical venous drainage which suggested that thrombosis of the sinuses probably propagated into the adjacent parietal cortical veins, and development of a dural-pial AVM at or near the site of thrombi in more than one cortical vein. Complete surgical excision of the lesion was accomplished without neurological deterioration.
The present case suggests the possibility that the pial AVM is not only a congenital condition but also may develop as an acquired lesion.
我们报告了一例罕见的静脉窦血栓形成后获得性硬脑膜-软脑膜动静脉畸形(AVM)病例。
一名39岁男性最初的血管造影显示上矢状窦(SSS)和右侧横窦(TS)血栓形成,但未发现血管畸形。29个月后的随访血管造影显示SSS和TS再通,逆行皮质静脉引流,提示静脉窦血栓可能蔓延至相邻的顶叶皮质静脉,并在不止一条皮质静脉的血栓部位或附近形成硬脑膜-软脑膜AVM。病变完整切除,未出现神经功能恶化。
本病例提示软脑膜AVM不仅可能是先天性疾病,也可能作为获得性病变发生。