Delayed Dural Arteriovenous Fistula after Microvascular Decompression for Hemifacial Spasm.
10.3340/jkns.2014.56.2.168
- Author:
Sung Han KIM
1
;
Won Seok CHANG
;
Hyun Ho JUNG
;
Jin Woo CHANG
Author Information
1. Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea. jchang@yuhs.ac
- Publication Type:Case Report
- Keywords:
Dural arteriovenous fistula;
Hemifacial spasm;
Microvascular decompression;
Retrosigmoid suboccipital craniotomy
- MeSH:
Amnesia;
Arteries;
Central Nervous System Vascular Malformations*;
Craniotomy;
Dysarthria;
Follow-Up Studies;
Hemifacial Spasm*;
Humans;
Intracranial Hemorrhages;
Magnetic Resonance Imaging;
Male;
Microvascular Decompression Surgery*;
Middle Aged;
Recurrence;
Spasm;
Thrombosis
- From:Journal of Korean Neurosurgical Society
2014;56(2):168-170
- CountryRepublic of Korea
- Language:English
-
Abstract:
Dural arteriovenous fistula (AVF) is very rare, acquired lesion that may present with intracranial hemorrhage or neurological deficits. The etiology is not completely understood but dural AVF often has been associated with thrombosis of the involved dural sinuses. To our knowledge, this is the first well documented intracranial hemorrhage case caused by dural AVF following microvascular decompression for hemifacial spasm. A 49-year-old male patient had left microvascular decompression of anterior inferior cerebellar artery via retrosigmoid suboccipital craniotomy. The patient was in good condition without any residual spasm or surgery-related complications. However, after 10 months, he suffered sudden onset of amnesia and dysarthria. Computed tomography and magnetic resonance imaging revealed the presence of dural AVF around the left transverse-sigmoid sinus. The dural AVF was treated with Onyx(R) (ev3) embolization. At the one-year follow up visit, there were no evidence of recurrence and morbidity related to dural AVF and its treatment. This case confirms that the acquired etiology of dural AVF may be associated with retrosigmoid suboccipital craniotomy for hemifacial spasm, even though it is an extremely consequence of this procedure.
