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Giant intracranial pial arteriovenous fistula treated by endovascular intervention.
MedLine Citation:
PMID:  22278788     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Arteriovenous fistulas (AVF) are rare vascular lesions of the brain that differ from arteriovenous malformations as they present a direct connection between artery and vein, without interposition of the nidus. They are fed by one or more arterial branches, with a single draining vein. Clinically they can be revealed through cerebral hemorrhage, convulsive crisis, neurological deficit, heart failure in neonates and infants, headache, bruit, or intracranial hypertension symptoms.A 30-year-old patient was found unconscious on a public street, presenting a generalized tonic-clonic convulsive crisis. At admission, she presented with ocular proptosis, conjunctival hyperemia and bilateral jugular turgescence. The cranial computed tomography showed diffuse subarachnoid hemorrhage, and the cerebral angiography evidenced a giant intracranial pial AVF with high flow supplied by 2 branches of the left anterior cerebral artery.The patient underwent endovascular treatment in 2 sessions, using a mixture of histoacryl and lipiodol for complete occlusion of the lesion. She was discharged after a month, alert, devoid of motor deficit, and the ocular proptosis and the conjunctival hyperemia had decreased.AVFs are rare vascular lesions that require prompt treatment. The endovascular treatment must be considered, especially when the lesions are deep and the risks of neurological deficit associated with the surgery are high. Endoscopic intervention represents an effective and safe option for the treatment of this type of lesion.
Authors:
G B de Aguiar; M L M Conti; J C E Veiga; M Jory
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Publication Detail:
Type:  Journal Article     Date:  2012-01-25
Journal Detail:
Title:  Minimally invasive neurosurgery : MIN     Volume:  54     ISSN:  1439-2291     ISO Abbreviation:  Minim Invasive Neurosurg     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2012-01-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440973     Medline TA:  Minim Invasive Neurosurg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  247-9     Citation Subset:  IM    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Affiliation:
Department of Surgery, Division of Neurosurgery, Santa Casa Medical School, São Paulo, Brazil.
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