[Ischemia of the sternocleidomastoid muscle following occipital artery embolization for dural arteriovenous fistula].
We report a case of localized ischemia of the sternocleidomastoid muscle (SCM) occurring after occipital artery embolization of a dural arteriovenous fistula (dAVF). A 45-year-old man presented intracerebral hemorrhage from a dAVF at the left transverse-sigmoid sinus. The dAVF had a high flow fistula from the left occipital artery (OA). Endovascular therapy was carried out one month later. Transarterial embolization of the OA was carried out prior to the transvenous approach to decrease the shunt flow. During obliteration of the proximal portion of the OA with fiber platinum coils and polyvinyl alcohol particles, the patient reported severe neck pain. The fistula was successfully embolized after transvenous packing of the left sigmoid sinus with detachable coils. The neck pain persisted for one week and disappeared after conservative treatment. T2-MR imaging 3 days after the embolization showed a hyperintensity in the left SCM. This ischemic lesion was probably induced by occlusion of the muscular branch of the OA. We discuss this common but rarely reported complication of OA embolization.
Fujimura
Naoko
N
Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan. fuji@med.kurume-u.ac.jp
Hirohata
Masaru
M
Abe
Toshi
T
Hara
Shinya
S
Shigemori
Minoru
M
D002342:Carotid Artery, External; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000628:therapy*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000098:blood supply*