[Spontaneous closure of a intracraneal dural arteriovenous fistula by controlled hypotension during a general anesthesia procedure. A case report].
Intracranial dural arteriovenous fistulas (DAVF) are arteriovenous communications within the duramater, which seem to be pathophysiologically related to a venous sinus thrombosis. DAVF may require invasive treatment, although rarely spontaneous occlusion has been reported. The present case is a 48-year-old male with a diagnosed type III DAVF of the right lateral sinus. Complete endovascular embolization was not possible to perform, so he was considered a candidate for surgical treatment. During perioperative management, under general anesthesia, the intraoperative arteriographyc monitoritation showed a spontaneous closure of the DAVF after induced controlled hypotension, resulting in complete cure. We conclude that controlled hypotension could become an alternative for treatment of DAVF in high risk patients or when there is no chance for embolization.patients or when there is no chance for embolization. Neurología 2003;18(10):746-749
Ornaque
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Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Ciudad Sanitaria de Belvitge, Hospitalet de Llobregat, Barcelona, Spain. 30036mol@comb.es
Alonso
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P
Martí Valeri
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C
de Miquel
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MA
Cambra
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R
Gabarrós
A
A
Conesa
G
G
D000768:Anesthesia, General; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002533:Cerebral Angiography; D004388:Dura Mater / Q000000981:diagnostic imaging*; D006801:Humans; D007022:Hypotension / Q000150:complications*; D008297:Male; D008875:Middle Aged