Document Detail

Thrombophilia Due to Factor V and Factor II Mutations and Formation of a Dural Arteriovenous Fistula: Case Report and Review of a Rare Entity.
MedLine Citation:
PMID:  18769649     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Genetic mutations underlying thrombophilia are often recognized in patients with thromboembolic episodes. However, the clinical and therapeutic implications of such findings often remain unclear. We report the first case of a dural arteriovenous fistula (DAVF) in a patient with a combined factor II and factor V Leiden mutation. A 40-year-old man presented with a large left temporal and intraventricular hemorrhage. An initial angiogram showed thrombosis of the left sigmoid sinus but no evidence of a vascular malformation. One year after the hemorrhage, an angiographic study showed the appearance of a right DAVF. During the follow-up period, the patient was found to harbor heterozygosity for a mutation of factor V and a mutation of factor II. Recognition of the patient's thrombophilia led to prolonged oral anticoagulation therapy to reduce the risk of a recurrent thrombotic episode. Despite the increased risk of bleeding, the therapy was considered justified. DAVFs may occur after sinus thrombosis in patients with combined factor II and factor V mutations. This observation indicates the association of multiple hematological disorders with DAVFs in individual patients. Moreover, it raises the clinical conundrum of how to manage patients with thrombophilia, intracranial hemorrhage, and DAVFs.
Sam Safavi-Abbasi; Federico Di Rocco; Peter Nakaji; Guenther C Feigl; Alireza Gharabaghi; Madjid Samii; Anton Valavanis; Amir Samii
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Skull base : official journal of North American Skull Base Society ... [et al.]     Volume:  18     ISSN:  1531-5010     ISO Abbreviation:  Skull Base     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-09-04     Completed Date:  2011-07-14     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  101090660     Medline TA:  Skull Base     Country:  United States    
Other Details:
Languages:  eng     Pagination:  135-43     Citation Subset:  -    
Department of Neurosurgery and Neuroradiology, International Neuroscience Institute, Hannover, Germany.
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