A Case of Iatrogenic Dural Artery-Pial Vein Shunt Treated with Endovascular Treatment.

Hideaki Shigematsu, Kazuma Yokota, Akihiro Hirayama, Takatoshi Sorimachi
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Abstract

Objective: A few cases of postsurgical iatrogenic arteriovenous shunts have been reported, with the arterial blood flow directly entering the pial veins. Herein, we reported a patient with a dural artery-pial vein shunt found 1 year after aneurysmal clipping.

Case presentation: A 64-year-old male presented with generalized convulsion 1 year after cerebral aneurysmal clipping. A CT showed intracerebral hemorrhage in the temporo-occipital cortex and a dural artery-pial vein shunt in proximity to the previous craniotomy center. The arterial blood flow from the deep temporal artery, the middle meningeal artery, and the anterior auricular branch of the superficial temporal artery shunted into the superficial middle cerebral vein, with evident cortical venous reflux. Embolization was performed with n-butyl-2-cyanoacrylate and completely occluded the shunt. The patient was discharged without neurological deficits.

Conclusion: Endovascular liquid embolization may be an effective treatment for iatrogenic dural artery-pial vein shunt.

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血管内治疗医源性硬脑膜动脉-颅静脉分流1例。
目的:报道少数术后医源性动静脉分流术,动脉血流直接进入颅底静脉。在此,我们报告了一位在动脉瘤夹闭1年后发现硬脑膜动脉-颅静脉分流的患者。病例介绍:一名64岁男性,在脑动脉瘤切除1年后出现全身抽搐。CT显示脑出血在颞枕皮质和硬脑膜动脉-动脉静脉分流靠近先前的开颅中心。动脉血流从颞深动脉、脑膜中动脉、颞浅动脉耳前支分流入大脑浅中静脉,有明显的皮质静脉回流。用正丁基-2-氰基丙烯酸酯进行栓塞,完全阻塞分流管。病人出院时没有神经功能缺损。结论:血管内液体栓塞是治疗医源性硬脑膜动-枕静脉分流的有效方法。
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