Development of a de novo cerebral arteriovenous malformation in a child with sickle cell disease and moyamoya arteriopathy. Case report.
The authors report the unique case of a 6-year-old African-American girl with sickle cell disease (SCD) and an associated moyamoya arteriopathy who developed a de novo arteriovenous malformation (AVM) of the cerebral circulation. Based on preoperative cerebral angiography, computerized tomography angiography, and magnetic resonance imaging, the incidentally discovered lesion was originally thought to be a direct arteriovenous fistula with an associated varix. At surgery, however, a 1.5-cm AVM was identified adjacent to the deep surface of the varix, and it was successfully resected. The diagnosis of cerebral AVM was then confirmed histopathologically. Based on a review of the literature, no published correlation between cerebral AVMs and SCD exists. In addition to reporting this case, the authors provide a description of AVM pathogenesis, with particular emphasis on acquired AVMs of the cerebral circulation.
O'Shaughnessy
Brian A
BA
Department of Neurological Surgery, The Feinberg School of Medicine, McGaw Medical Center, The Children's Memorial Hospital, Northwestern University, Chicago, Illinois 60611, USA.
DiPatri
Arthur J
AJ
Parkinson
Richard J
RJ
Batjer
H Hunt
HH
D000755:Anemia, Sickle Cell / Q000150:complications*; D001284:Atrophy / Q000000981:diagnostic imaging / Q000473:pathology; D002545:Brain Ischemia / Q000473:pathology; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002540:Cerebral Cortex / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis*; D009072:Moyamoya Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D019635:Neurosurgical Procedures; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis / Q000601:surgery