Usefulness of Embolization for Iatrogenic Dural Arteriovenous Fistula Associated with Recurrent Chronic Subdural Hematoma: A Case Report and Literature Review

Tushit Mewada, Tomotaka Ohshima, Taiki Yamamoto, Shunsaku Goto, Yoko Kato

研究成果: Article査読

6 被引用数 (Scopus)

抄録

Background Refractory chronic subdural hematomas due to iatrogenic dural arteriovenous fistulas (dAVFs) are difficult to treat. We report our experience and propose a guideline on basis of a literature review for the usefulness of embolization of middle meningeal artery (MMA) for the treatment of the same. Case Description We report a case with right hemiparesis and aphasia 1 month after a fall from a bicycle. Computed tomography scan of the head showed left chronic subdural hematoma, which was evacuated by burr-hole drainage. The postoperative course was complicated by reaccumulation within short period of time. On superselective digital subtraction angiography of MMA, iatrogenic dAVF was found on left side. We embolized successfully it using n-butyl cyanoacrylate after a third irrigation. No reaccumulation found in the postoperative period or at last follow-up. We propose treatment protocol based on our experience and literature review. Conclusion Refractory chronic subdural hematoma with reaccumulation within a short interval should be subjected to digital subtraction angiography of the MMA. Embolization of ipsilateral MMA is safe, effective, and a useful option for the treatment of iatrogenic dAVF and resolution of hematoma.

本文言語English
ページ(範囲)584.e7-584.e10
ジャーナルWorld Neurosurgery
92
DOI
出版ステータスPublished - 01-08-2016

All Science Journal Classification (ASJC) codes

  • 外科
  • 臨床神経学

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