11/295. A dural arteriovenous fistula of the tentorium successfully treated by intravascular embolization.BACKGROUND: Dural arteriovenous fistulas of the tentorium are rare lesions that often present with intracranial hemorrhage. Definitive treatment is therefore necessary, but transarterial embolization has rarely been curative. CASE DESCRIPTION: A 59-year-old man presenting with sudden onset of severe headache had subarachnoid hemorrhage demonstrated by computed tomography. Left carotid angiography showed a tentorial dural arteriovenous fistula fed by a tentorial branch from the internal carotid artery and by a middle meningeal artery; the fistula drained to the marginal sinus via a dilated varicosity. Transarterial embolization successfully obliterated the fistula, and the patient was discharged with no neurologic deficit. CONCLUSION: This tentorial fistula, that showed extremely rare angiographic features, particularly venous drainage, was embolized successfully. The literature concerning tentorial dural arteriovenous fistulas is discussed in terms of effective therapeutic choice.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
12/295. brachial plexus and supraclavicular nerve injury caused by manual carotid compression for spontaneous carotid-cavernous sinus fistula.BACKGROUND: Manual carotid compression is an established treatment for a spontaneous carotid-cavernous sinus fistula unless emergency treatment is required for it. CASE REPORT: A 63-year-old woman presented with a spontaneous carotid-cavernous sinus fistula. Manual carotid compression of 5 minutes duration, twice a day, for 10 days resulted in injury to the upper trunk (C 5-6) of the brachial plexus and the supraclavicular nerve (C 3-4), which subsequently resolved within a month after cessation of the procedure. CONCLUSION: It is important to know the possible neurological complications of manual carotid compression.- - - - - - - - - - ranking = 0.19526156409196keywords = upper (Clic here for more details about this article) |
13/295. A case of intracranial dural arteriovenous fistula draining into the spinal medullary veins.Intracranial dural arteriovenous fistulas draining into the spinal medullary veins (ICDAVFMs) are exceedingly rare lesions. Their diagnosis is difficult and is often made late. About twenty well documented cases have been published. We report a case in a 55-year-old woman who presented with persistent interscapular pain and neurological evidence of ascending myelopathy after therapy for cervicobrachial neuralgia. ICDAVFM should be considered by rheumatologists in patients with clinical and radiological findings suggestive of spinal cord disease, particularly if these findings indicate involvement of the medulla oblongata or cervical spinal cord.- - - - - - - - - - ranking = 0.88045566574162keywords = pain (Clic here for more details about this article) |
14/295. Left internal mammary artery to innominate vein fistula complicating pacemaker insertion. Treatment with endovascular transarterial coil embolization.arteriovenous fistula (AVF) is rarely encountered as a complication of pacemaker insertion. Percutaneous angiographic therapy of such iatrogenic fistulas can be both safe and effective, leading to important reductions in costs. A 60-year-old woman was admitted to the hospital four weeks after left subclavian pacemaker insertion complaining of signs of congestive heart failure. A loud continuous machinery bruit was heard over the left upper chest. An arteriogram revealed a false aneurysm from the LIMA, 6 mm in-diameter, with formation of an AVF between the LIMA and the left innominate vein. Embolization of the LIMA was carried out using seven platinum coils at the level of the AVF and the false aneurysm was embolized with 3 controlled-release IDC coils. The complete occlusion of the fistula was achieved and the distal LIMA persisted patent due to the opening of collateral vessels from the intercostal arteries. AVF between the subclavian artery or its branches and the subclavian or innominate veins have been reported to be congenital, traumatic and iatrogenic (associated to central venous access to hemodynamic monitoring, dialysis, and very infrequently to pacemaker insertion) but the internal mammary arteries are only rarely involved. The course of AVF is undefined, but generally, surgical or percutaneous embolization is warranted because of the potential appearance of a great number of complications. Surgical repair is associated with significant morbidity and mortality. Whenever possible, percutaneous nonsurgical occlusion of the AVF with coil embolization is the procedure of choice, because of its high success rate and low morbidity.- - - - - - - - - - ranking = 0.76426108535884keywords = chest, upper (Clic here for more details about this article) |
15/295. Coronary arteriovenous fistula with a giant aneurysm: role of transesophageal echocardiography.Congenital coronary arteriovenous fistulas are rare anomalies. patients may present with congestive heart failure, ischemic chest pain, or endocarditis. In this case, transesophageal echocardiography provided valuable additional information to that obtained from cardiac catheterization, which was essential for the diagnosis and planning of surgical correction.- - - - - - - - - - ranking = 1.4494551870085keywords = pain, chest (Clic here for more details about this article) |
16/295. Intracranial dural arteriovenous fistulae with perimedullary venous drainage. Anatomical, clinical and therapeutic considerations.We report five cases of intracranial dural arteriovenous fistula (DAVF) with perimedullary venous drainage. All the patients presented with rapidly progressive myelopathy and three had autonomic disorders. The DAVF were on the tentorium cerebelli (two cases), sigmoid (one), superior petrosal (one), and cavernous sinus (one). Slow venous drainage was directed through dilated perimedullary cervical veins. The transverse sinus was occluded in two cases. MRI, performed in four cases, demonstrated high signal on T2-weighted spin-echo sequences in the medulla oblongata and upper cervical spinal cord consistent with oedema, which signal resolved after complete cure of the DAVF in three cases. Embolisation was performed in all cases. It was followed by clinical deterioration in two cases and in the dramatic improvement in the other three, with complete clinical cure in two. Extensive venous thrombosis may explain the deterioration observed in one case.- - - - - - - - - - ranking = 0.19526156409196keywords = upper (Clic here for more details about this article) |
17/295. Stereotactic radiosurgery for tentorial dural arteriovenous fistulae draining into the vein of Galen: report of two cases.OBJECTIVE AND IMPORTANCE: Treatment of tentorial dural arteriovenous fistulae (DAVFs) primarily draining into the vein of Galen remains a therapeutic challenge. We present two cases of ruptured galenic DAVFs that were successfully treated with gamma knife radiosurgery. CLINICAL PRESENTATION: Patient 1, a 66-year-old woman, experienced a sudden onset of headache and loss of consciousness. neuroimaging studies revealed intraventricular hemorrhage and a DAVF with aneurysmal dilation of the vein of Galen. The DAVF was supplied by tentorial branches of the right meningohypophyseal artery and bilateral supracerebellar arteries, which drained directly into the vein of Galen. Patient 2, a 64-year-old woman, experienced subarachnoid hemorrhage. cerebral angiography revealed a galenic DAVF at the falcotentorial junction, which was supplied by bilateral supracerebellar arteries. This patient had an aneurysm at the origin of the left supracerebellar artery. INTERVENTION: Both patients were treated with gamma knife radiosurgery. In each case, the fistula was exclusively targeted and a dose of more than 20 Gy was delivered. Complete obliteration of the fistula was confirmed 27 and 29 months after radiosurgery for patients 1 and 2, respectively, whereas the normal venous structures of the galenic system were preserved. CONCLUSION: Gamma knife radiosurgery is an effective treatment modality for DAVFs primarily draining into the vein of Galen. Irradiation doses of more than 20 Gy, strictly limited to the fistulae, seem to be sufficient for successful obliteration of these high-risk vascular lesions, with minimal invasiveness.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
18/295. Embolization of a pulmonary arteriovenous fistula by electrolytic detachable coils: case report.Transarterial embolization with detachable coils is a technique commonly used for the treatment of intracranial aneurysms. We report on a patient with a pulmonary arteriovenous fistula (PAVF) treated successfully with this technique. The patient presented with a history of intermittent hemoptysis, nasal bleeding, numbness of the upper extremities, and seizures. Computed tomographic angiography and magnetic resonance angiography demonstrated a single-hole arteriovenous fistular lesion in the left lower lung. Pre-embolization superselective pulmonary angiography revealed multiple fistulae communicating to the venous sac of the lesion. Eleven detachable coils were deployed into the venous sac, with resultant total occlusion of the pulmonary arteriovenous fistula. We conclude that venous sac embolization in treating this kind of patients is effective. The combined use of a microcatheter system and electrolytic detachable coils may be an excellent technique for achieving this kind of embolization. Superselective angiographic evaluation is essential before embolization, because many occult feeders can be present in cases of high-flow PAVF.- - - - - - - - - - ranking = 0.19526156409196keywords = upper (Clic here for more details about this article) |
19/295. Abdominal aortic aneurysm with aorta-left renal vein fistula with left varicocele.Abdominal aortic aneurysm with spontaneous aorto-left renal vein fistula is a rare but well-described clinical entity usually with abdominal pain, hematuria, and a nonfunctioning left kidney. This report describes a 44-year-old man with left-sided groin pain and varicocele who was treated with conservative measures only. The diagnosis was eventually made when he returned with microscopic hematuria, elevated serum creatinine level, and nonfunction of the left kidney; computed tomography scan demonstrated a 6-cm abdominal aortic aneurysm, a retroaortic left renal vein, and an enlargement of the left kidney. This patient represents the youngest to be reported with aorto-left renal vein fistula and the second case with a left-sided varicocele.- - - - - - - - - - ranking = 4.2674086781259keywords = abdominal pain, pain (Clic here for more details about this article) |
20/295. Unusual signs for dural arteriovenous fistulas with diffuse basal ganglia and cerebral calcification.We present a case of multiple dural arteriovenous fistulas (AVFs) in a 60-year-old man with the chief complaint of worsening headache, altered mental status and progressively unsteady gait over the course of one year. Computerized tomography revealed diffuse, symmetric calcification in the bilateral basal ganglia and bilateral periventricular and subcortical white matter. magnetic resonance imaging revealed multiple, enhanced, punctate and linear vessels. These images were due to reflux into the parenchymal veins in the dural AVF of the superior sagittal sinus within the basal ganglia and deep white matter of both cerebral hemispheres. cerebral angiography disclosed multiple dural AVFs. The exact mechanism of basal ganglia and subcortical calcification is proposed to be an arterial steal phenomenon or persistent venous congestion, with calcification occurring in a chronic hypoperfused state or with dystrophic changes in the walls of congested veins.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
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