Iatrogenic Dural Arteriovenous Fistula after Superficial Temporal Artery to Middle Cerebral Artery Anastomosis: A Case Report.
10.13004/kjnt.2015.11.2.151
- Author:
Seng Won KIM
1
;
Kil Sung CHAE
;
Jae Hyon SHIM
;
Seung Jin RHO
;
Hak Ki CHOI
;
Hwa Seung PARK
Author Information
1. Department of Neurosurgery, Bongseng Memorial Hospital, Busan, Korea. drkschae@gmail.com
- Publication Type:Case Report
- Keywords:
Central nervous system vascular malformations;
Cerebral revascularization;
Meningeal arteries;
Middle cerebral artery
- MeSH:
Angiography;
Brain;
Central Nervous System Vascular Malformations*;
Cerebral Infarction;
Cerebral Revascularization;
Constriction, Pathologic;
Craniotomy;
Dysarthria;
Fistula;
Follow-Up Studies;
Humans;
Infarction;
Magnetic Resonance Imaging;
Meningeal Arteries;
Middle Aged;
Middle Cerebral Artery*;
Paresis;
Temporal Arteries*;
Veins
- From:Korean Journal of Neurotrauma
2015;11(2):151-153
- CountryRepublic of Korea
- Language:English
-
Abstract:
Dural arteriovenous fistulas (AVFs) are uncommon, representing only 10% to 15% of all intracranial AVFs. Here we present the case of a patient with cerebral infarction who experienced a dural AVF after craniotomy for superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery. A 48-year-old man presented with dysarthria and right side hemiparesis. A brain magnetic resonance imaging scan revealed multiple acute infarctions and severe stenosis of the left MCA. Therefore, STA-MCA bypass surgery was performed. A follow-up angiography performed 2 weeks after the surgery showed an abnormal vascular channel from the left middle meningeal artery (MMA) to the middle meningeal vein (MMV) just anterior to the border of the craniotomy margin. This fistula originated from a screw used for cranial fixation. The screw injured the MMA and MMV, and this resulted in the formation of a fistula. The fistula was successfully treated with transarterial embolization. Surgeons should be careful when fixing bones with screws and plates as fistulas can develop if vessels are injured.
