Giant tentorial dural arteriovenous fistula treated by a combination of trans-arterial embolization and surgery


Karanci T., Akdemir H., AYDIN K.

INDIAN JOURNAL OF NEUROSURGERY, cilt.1, sa.2, ss.144-148, 2012 (ESCI) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 1 Sayı: 2
  • Basım Tarihi: 2012
  • Doi Numarası: 10.4103/2277-9167.102285
  • Dergi Adı: INDIAN JOURNAL OF NEUROSURGERY
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI)
  • Sayfa Sayıları: ss.144-148
  • Anahtar Kelimeler: Surgery, tentorial dural arterio-venous fistula, trans-arterial embolization
  • İstanbul Üniversitesi Adresli: Evet

Özet

Tentorial dural arteriovenous fistulae are uncommon lesions but can be life-threatening. A 34-year-old male presented with intractable headache, seizures, and visual disturbance. Three-dimensional computed tomography (CT) angiography and digital subtraction angiography demonstrated a right tentorial dural arteriovenous fistula supplied by both internal and external carotid systems and draining into a giant venous ampula. Transarterial embolization of the external carotid feeders with Onyx (TM, ev3, Irvine, CA) was carried out. Postembolization angiography revealed persistence of a portion of the fistula supplied by the temporo-occipital branch of right middle cerebral artery. The patient underwent right temporo-occipital craniotomy, division of the feeders and resection of the entire fistula and coagulation of the leptomeningeal arterialized veins. Complete elimination of the fistula was demonstrated by angiography. Postoperative recovery was uneventful; the patient did not develop any fresh neurologic deficits. We review the relevant literature and discuss the rationale for managing these lesions.