[A case of posttraumatic vascular abnormality similar to dural arteriovenous malformation].
A case of posttraumatic vascular abnormality similar to dural arteriovenous malformation is reported. A 21-year-old man was injured in the traffic accident and admitted to our hospital with comatose state. Bilateral carotid angiograms revealed no abnormal findings. Then, he was treated conservatively as a diagnosis of cerebral contusion. Nine years after the initial admission, he was fallen into comatose state suddenly and admitted to a local hospital. On the next day, he was transferred to our hospital. Neurological examination disclosed comatose state, right oculomotor palsy, and left hemiparesis. CT scan showed a crescent shaped high density area in the right subdural space, right temporal intracerebral high density area, and left frontal low density area, suggesting right acute subdural hematoma, right temporal intracerebral hematoma, and left frontal old cerebral contusion respectively. Right carotid angiogram revealed an abnormal vascularity in the right middle fossa, which was fed by the middle meningeal artery and drained into the superior sagittal sinus and the transverse sinus. Surgical treatment was performed immediately. Following the evacuation of intracerebral hematoma, the abnormal vascular mass suggesting a nidus of arteriovenous malformation was removed totally, that was attached to the dura mater. Pathological specimen showed large veins and arteries with thrombus, however, no characteristic feature of arteriovenous malformation. Then, this was thought to be an arteriovenous fistula between the branches of middle meningeal artery and the veins of fibroglial scar following by the cerebral contusion.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D001921:Brain / Q000473:pathology; D001924:Brain Concussion / Q000150:complications* / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D004388:Dura Mater / Q000098:blood supply*; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis; D008297:Male