Cerebral abscess as an unusual complication of coil embolization in a dural arteriovenous fistula

1997 ◽  
Vol 87 (1) ◽  
pp. 109-112 ◽  
Author(s):  
Adnan A. Rahman Zurin ◽  
Satoshi Ushikoshi ◽  
Kiyohiro Houkin ◽  
Yoichi Kikuchi ◽  
Hiroshi Abe ◽  
...  

This 63-year-old man presented with a right temporoparietal cortical infarction. A dural arteriovenous fistula involving the right transverse sinus was diagnosed on cerebral angiography. Transvenous embolization using detachable coils was performed; however, postembolization angiograms demonstrated retrograde filling of a cortical draining vein that was not seen on initial angiography. The patient subsequently developed a cerebral abscess in the region of the previous cortical infarction 2 months after the embolization. The abscess was successfully treated with drainage and antibiotic therapy. The authors report this case to illustrate an unusual complication associated with this procedure and the possible contribution of the cortical draining vein in the pathogenesis of the cerebral abscess.

1997 ◽  
Vol 2 (4) ◽  
pp. E12
Author(s):  
Adnan Abd. Rahman Zurin ◽  
Satoshi Ushikoshi ◽  
Kiyohiro Houkin ◽  
Yoichi Kikuchi ◽  
Hiroshi Abe ◽  
...  

This 63-year-old man presented with a right temporoparietal cortical infarction. A dural arteriovenous fistula involving the right transverse sinus was diagnosed on cerebral angiography. Transvenous embolization using detachable coils was performed; however, postembolization angiograms demonstrated retrograde filling of a cortical draining vein that was not seen on initial angiography. The patient subsequently developed a cerebral abscess in the region of the previous cortical infarction 2 months after the embolization. The abscess was successfully treated with drainage and antibiotic therapy. The authors report this case to illustrate an unusual complication associated with this procedure and the possible contribution of the cortical draining vein in the pathogenesis of the cerebral abscess.


2021 ◽  
pp. 197140092110415
Author(s):  
Takuya Osuki ◽  
Hiroyuki Ikeda ◽  
Tomoko Hayashi ◽  
Silsu Park ◽  
Minami Uezato ◽  
...  

Background There is no consensus as to whether balloon angioplasty alone or stent placement is effective for sinus occlusion associated with dural arteriovenous fistula (DAVF). Herein, we first report a case of transverse sinus occlusion associated with DAVF in which gradual sinus dilatation was observed after balloon angioplasty with embolization of the affected sinus with shunt flow. Case presentation A 69-year-old man presented with executive dysfunction. Magnetic resonance imaging revealed left transverse sinus–sigmoid sinus DAVF with occlusion of the left jugular vein and right transverse sinus. Before endovascular treatment, the patient had symptomatic epilepsy and subarachnoid hemorrhage. Retrograde leptomeningeal venous drainage disappeared with packing of the left transverse sinus–sigmoid sinus. Subsequently, balloon angioplasty of the right occluded transverse sinus was performed to maintain the normal venous drainage and remaining shunt outflow. Dilatation of the right transverse sinus was poor immediately after surgery. However, angiography after 10 days and 6 months revealed gradual dilatation of the right transverse sinus. Conclusion Sinus occlusion, which is thought to be caused by sinus hypertension associated with DAVF rather than chronic organized thrombosis or thrombophilia, may dilate over time after balloon angioplasty and shunt flow reduction if occluded sinus is necessary for facilitating normal venous drainage.


2021 ◽  
Vol 12 ◽  
pp. 413
Author(s):  
Ryota Ishibashi ◽  
Yoshinori Maki ◽  
Hiroyuki Ikeda ◽  
Masaki Chin

Background: Tentorial dural arteriovenous fistula (TDAVF) is a rare intracranial vascular shunt. A TDAVF can be supplied by the Artery of Wollschlaeger and Wollschlaeger (AWW). However, a limited number of cases of TDAVF fed by the AWW have been reported to date. Case Description: A 70-year-old woman complaining of the right motor weakness underwent magnetic resonance imaging. A vascular lesion beneath the cerebellar tentorium was incidentally found with chronic infarction of the left corona radiata. Angiographically, the vascular lesion was a TDAVF supplied by the bilateral posterior meningeal arteries. No other apparent feeders were detected. The TDAVF had a shunting point on the inferior surface of the cerebellar tentorium with venous retrograde flow (Borden type III, Cognard type III). To prevent vascular events, endovascular embolization was performed using n-butyl-2-cyanoacrylate. Following embolization of the shunting point, a residual shunt fed by the AWW was identified. The shunt supplied by the AWW was not observed preoperatively. Follow-up angiography performed 1 week later revealed spontaneous disappearance of the residual shunt. The patient was followed-up in our outpatient clinic, and no recurrence of the TDAVF was confirmed postoperatively. Conclusion: Detection of mild feeding from the AWW to a TDAVF can be elusive preoperatively. Following embolization of the main shunting point, residual shunting from the AWW can resolve spontaneously.


2002 ◽  
Vol 97 (2) ◽  
pp. 467-470 ◽  
Author(s):  
John B. Weigele ◽  
John C. Chaloupka ◽  
Walter S. Lesley

✓ The authors report a case in which the clinical and neuroimaging findings were initially considered diagnostic of a brainstem glioma. Angiography revealed a deep venous system (galenic) dural arteriovenous fistula causing brainstem interstitial edema. Successful endovascular surgery resulted in complete clinical recovery of the patient and resolution of the structural abnormalities that had been observed on magnetic resonance images. The neuroimaging and therapeutic significance of this case are discussed.


2003 ◽  
Vol 145 (6) ◽  
pp. 501-504 ◽  
Author(s):  
N. Horinaka ◽  
Y. Nonaka ◽  
T. Nakayama ◽  
K. Mori ◽  
R. Wada ◽  
...  

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONSE89-ONS93 ◽  
Author(s):  
Michael E. Kelly ◽  
Raymond Turner ◽  
Vivek Gonugunta ◽  
Peter A. Rasmussen ◽  
Henry H. Woo ◽  
...  

Abstract Objective: Microcatheters retained after Onyx (eV3 Neurovascular, Inc., Irvine, CA) embolization represent a potential source of thromboembolic complications. Catheter retention depends on the degree of Onyx reflux and vessel tortuosity. To overcome this problem, we have adapted a previously described monorail snare technique for stretched coils to remove an adherent microcatheter from the occipital artery during Onyx embolization of a dural arteriovenous fistula. Clinical Presentation: We used this technique successfully in a 62-year-old man with a posterior fossa dural arteriovenous fistula. An Echelon-10 microcatheter (eV3 Neurovascular, Inc.) system became adherent in the right occipital artery because of reflux and vessel tortuosity. Significant stretching of the microcatheter was observed during attempted removal. Intervention: A 2-mm Amplatz Goose Neck microsnare (Microvena Corp., White Bear Lake, MN) was placed through a Rapid Transit microcatheter (Cordis Corp., Miami, FL). The hub of the indwelling Echelon microcatheter was cut off and the snare advanced over the outside of the microcatheter. The snare and Rapid Transit microcatheter were then advanced into the guiding catheter (6-French) as a unit over the indwelling Echelon microcatheter. Using the adherent Echelon as a “monorail” guide, the snare and Rapid Transit microcatheter were advanced distally into the occipital artery and the snare was retracted to engage the microcatheter. The microcatheters and snare were then easily removed because of the second vector of force placed by the snare system on the adherent microcatheter very close to the point of adherence. Conclusion: The monorail snare technique represents a simple and safe way to remove an adherent microcatheter from an Onyx cast during the embolization of dural arteriovenous fistulas. Prospective knowledge of this technique will facilitate more aggressive embolization without the reservation that a retained microcatheter could require surgical removal or anticoagulation.


1991 ◽  
Vol 75 (6) ◽  
pp. 947-949 ◽  
Author(s):  
Dong-Ik Kim ◽  
In-Sup Choi ◽  
Alex Berenstein

✓ The case is reported of a woman with a spinal dural arteriovenous fistula whose intermittent myelopathy became aggravated with menstruation. Her symptoms recurred in spite of successful acrylic embolization of the lateral sacral arteriovenous fistula. Repeat angiography showed venous drainage from the uterus toward the medullary vein. Total abdominal hysterectomy cured her symptoms. The pathophysiological basis for this peculiar clinical manifestation and its management are discussed.


1996 ◽  
Vol 84 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Toshisuke Sakaki ◽  
Tetsuya Morimoto ◽  
Hiroyuki Nakase ◽  
Toshio Kakizaki ◽  
Kiyoshi Nagata

✓ In this article, the authors present five cases of dural arteriovenous fistula (AVF) that developed in the transverse—sigmoid sinus 2 to 6 years after sacrifice of the sigmoid sinus because of tumor involvement. The original tumor was meningioma in two patients and neurinoma, glomus jugulare tumor, and ameloblastoma in one patient each. The involved sigmoid sinus was resected along with the tumor and ligated at the normal edge; all that remained of the sigmoid sinus was a small stump on the retrosigmoid portion. Serial angiography performed before and after tumor surgery revealed no abnormal arteriovenous communications or dural AVF in any of the cases. Although many reports have suggested that sinus thrombosis is a precipitating factor in the pathogenesis of dural AVFs, this has been difficult to verify because of the small number of cases in which serial angiography was performed before the development of a dural AVF. In all of the cases presented in this article, surgical resection of a dural AVF and histological examination were performed. Subintimal fibrous thickening was marked, and the sinus wall was found to contain many dural vessels. Organized thrombosis with neovascularization was seen in only two patients. These cases demonstrate that subintimal fibrous thickening and a hypertrophied sinus wall secondary to increased intrasinus pressure or sinus thrombosis occurring after sinus occlusion can provoke the development of a dural AVF within the course of a lifetime. Maintenance of intrasinus blood flow may be very important to prevent this late postoperative complication.


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