Title

An Intraoperative Look at a Residual/Recurrent Tentorial Dural Arteriovenous Fistula

Document Type

Article

Abstract

BACKGROUND: Dural arteriovenous fistulas (dAVFs) often are treated via transarterial or transvenous embolization. Incomplete penetration of the draining vein/occult residual often will become apparent on follow-up angiography, requiring repeat embolization, or at times, surgical resection. CASE DESCRIPTION: A 41-year-old woman presented with cerebellar hemorrhage from a tentorial dAVF treated with transvenous coil embolization. Follow-up angiography disclosed a residual/recurrent fistula treated with transvenous Onyx embolization. After further follow-up angiography demonstrated another occult residual/recurrence, the fistula was disconnected with the tentorial dura excised via a retrosigmoid approach. Six-month follow-up angiography demonstrated no recurrence. CONCLUSIONS: Although endovascular treatment of dAVFs is generally first-line therapy, surgical disconnection of fistulas, particularly high-risk residual/recurrent fistulas, is an excellent option in well-selected cases.

Keywords

Arteriovenous fistula, Dural arteriovenous fistula, Embolization, Recurrence, Surgery

Medical Subject Headings

Adult; Central Nervous System Vascular Malformations (diagnostic imaging, surgery); Female; Humans; Monitoring, Intraoperative (methods); Recurrence; Spinal Cord (diagnostic imaging, surgery)

Publication Date

9-1-2017

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

105

First Page

1043.e7

Last Page

1043.e9

PubMed ID

28711532

Digital Object Identifier (DOI)

10.1016/j.wneu.2017.07.015

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