A falcotentorial dural arteriovenous fistula presented as carotid cavernous fistula clinically treated by transarterial embolization: case report.

Q2 Medicine Chinese Neurosurgical Journal Pub Date : 2022-12-14 DOI:10.1186/s41016-022-00309-w

Yuan Shi, Peixi Liu, Yingtao Liu, Kai Quan, Yanlong Tian, Wei Zhu

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Abstract

Background: Dural arteriovenous fistulas (DAVF) represent almost 10-15% of intracranial malformations that cause intracranial hemorrhage and focal neurological deficits. Seldom tentorial DAVF cases present with ocular manifestations initially, which occur frequently in carotid-cavernous fistula (CCF) and cavernous sinus DAVF (CS DAVF).

Case presentation: We report an unusual falcotentorial DAVF case draining via the superior and inferior ophthalmic veins that caused left-side increased intraocular pressure. The patient's chief complaint was swelling on the left side, pain and conjunctival congestion. He received endovascular embolization via a transarterial approach, and postoperative angiography demonstrated that the falcotentorial DAVF was occluded completely.

Conclusion: Except for CCF and CS DAVF, some specific subtypes of DAVF should be considered if the patient initially presents with ocular symptoms. Differential diagnosis and definitive treatment are mandatory to avoid a delayed diagnosis and irreversible symptoms.

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经动脉栓塞治疗镰状脑膜动静脉瘘临床表现为颈动脉海绵瘘1例。

背景:硬脑膜动静脉瘘(DAVF)占颅内畸形的近10-15%，导致颅内出血和局灶性神经功能缺损。幕部DAVF很少以眼部为首发表现，多见于颈海绵状瘘(CCF)和海绵窦DAVF (CS DAVF)。病例介绍:我们报告一个不寻常的镰状眼静脉瘘病例，通过眼上和眼下静脉引流，导致左侧眼压升高。病人的主诉是左侧肿胀、疼痛和结膜充血。经动脉入路行血管内栓塞术，术后血管造影显示镰幕DAVF完全闭塞。结论:除CCF和CS型DAVF外，如果患者最初出现眼部症状，应考虑一些特定亚型的DAVF。鉴别诊断和明确治疗是必要的，以避免延误诊断和不可逆转的症状。

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