TY - JOUR
T1 - Dural arteriovenous fistula presenting with acute subdural haematoma showing impending cerebral herniation
AU - Suyama, Yoshio
AU - Wakabayashi, Shinichi
AU - Kajikawa, Hiroshi
AU - Nakahara, Ichiro
N1 - Publisher Copyright:
© 2018 Author(s) (or their employer(s)). No commercial re-use. See rights and permissions.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018
Y1 - 2018
N2 - A dural arteriovenous fistula (DAVF) presenting with acute subdural haematoma (ASDH), which were not related to head injury, is rare. A 61-year-old woman was transported by ambulance because of deterioration of consciousness. On admission, she was comatose with anisocoria. Emergent CT demonstrated a severe midline shift associated with a left ASDH and an additional left occipital intracerebral haematoma, both of which had no continuity with each other. MRI showed flow void signs in the left occipital lobe. Because of the impending cerebral herniation, an emergent evacuation of the ASDH and external decompression was performed. Subsequent evaluation revealed a DAVF at the left occipital convexity near the confluence with retrograde leptomeningeal venous reflux and venous ectasia (Cognard type III DAVF). The patient underwent endovascular treatment for the DAVF involving transarterial embolisation using coils and N-butyl cyanoacrylate with complete obliteration. Her further clinical course was uneventful and discharged after cranioplasty.
AB - A dural arteriovenous fistula (DAVF) presenting with acute subdural haematoma (ASDH), which were not related to head injury, is rare. A 61-year-old woman was transported by ambulance because of deterioration of consciousness. On admission, she was comatose with anisocoria. Emergent CT demonstrated a severe midline shift associated with a left ASDH and an additional left occipital intracerebral haematoma, both of which had no continuity with each other. MRI showed flow void signs in the left occipital lobe. Because of the impending cerebral herniation, an emergent evacuation of the ASDH and external decompression was performed. Subsequent evaluation revealed a DAVF at the left occipital convexity near the confluence with retrograde leptomeningeal venous reflux and venous ectasia (Cognard type III DAVF). The patient underwent endovascular treatment for the DAVF involving transarterial embolisation using coils and N-butyl cyanoacrylate with complete obliteration. Her further clinical course was uneventful and discharged after cranioplasty.
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U2 - 10.1136/bcr-2017-223177
DO - 10.1136/bcr-2017-223177
M3 - Article
C2 - 29950494
AN - SCOPUS:85049150420
VL - 2018
JO - BMJ Case Reports
JF - BMJ Case Reports
SN - 1757-790X
M1 - bcr-2017-223177
ER -