Angiographic disappearance of multiple dural arteriovenous malformations

Case report

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✓ Angiographic disappearance of two dural arteriovenous malformations (AVM's) in different locations in one case is reported. One of the AVM's involved the right transverse sinus, and the other involved the superior sagittal sinus. The patient's presenting symptoms were due to obstructive hydrocephalus resulting from a small intraventricular hemorrhage that was diagnosed by computerized tomography on admission. The symptoms cleared 25 hours after the ictus in conjunction with improvement of hydrocephalus. The AVM involving the right transverse sinus was supplied by the occipital artery, but ligation of that artery was not successful in eliminating the anomaly. One year later, follow-up angiography revealed disappearance of both dural AVM's.

Article Information

Address reprint requests to: Mamoru Taneda, M.D., Department of Neurosurgery, Hanwa Memorial Hospital, 11-11, Karita-7, Sumiyoshi-ku, Osaka 558, Japan.

© AANS, except where prohibited by US copyright law.

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Figures

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    Computerized tomography scans on admission showing ventricular dilatation, a small intraventricular hemorrhage, and hemorrhage of the right tentorium cerebelli.

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    Computerized tomography scans 25 hours after the ictus showing improvement of hydrocephalus and resolution of the intraventricular hemorrhage.

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    Preoperative right external carotid angiograms. Left: Lateral view demonstrating a dural arteriovenous malformation (AVM) involving the right transverse sinus mainly supplied by the occipital artery. Arrow indicates the site of the dural AVM involving the superior sagittal sinus. Note the dilated branches of the external carotid artery. Right: Enlarged lateral view, late arterial phase. The dural AVM involving the superior sagittal sinus is mainly supplied by dilated branches of the superior temporal artery. Note early filling of the superior sagittal sinus.

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    Left: Anteroposterior view of the preoperative right external carotid angiogram. Early phase demonstrating the dural arteriovenous malformation involving the right transverse sinus. The transverse sinus is occluded at both ends (arrows). Center: Lateral view of the preoperative right external carotid angiogram. Late phase demonstrating retrograde venous drainage through the superficial cerebral vein. Right: Anteroposterior view of the preoperative right internal carotid angiogram, venous phase. The right transverse sinus is not opacified.

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    Postoperative right external carotid angiograms. Left: Lateral view demonstrating a decrease in size of the arteriovenous malformation (AVM) involving the right transverse sinus. Note occlusion of the occipital artery (arrow). Right: Enlarged lateral view, late arterial phase, demonstrating an increase in size of the AVM involving the superior sagittal sinus.

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    Right external carotid angiograms 14 months after onset of symptoms. Left: Lateral view. The arteriovenous malformations (AVM's) are not visible. Branches of the external carotid artery are normal in caliber. Right: Lateral enlarged view, late arterial phase. The AVM is not opacified.

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