[High-flow arteriovenous fistula of the central nervous system associated with hereditary haemorrhagic telangiectasia].
The authors reported three cases of high flow arteriovenous fistula (AVF) associated with hereditary haemorrhagic telangiectasia (HHT). The first case was a 9-month-old boy who presented with subarachnoid hemorrhage (SAH). Digital subtraction angiography (DSA) revealed a perimedullary AVF at the cervical spine and the fistula was successfully interrupted by transarterial embolization with no additional neurological deficits. The second case was his mother, a 29-year-old women. She also had history of epistaxis, so imaging screens of her central nervous system (CNS) were undertaken. MRI showed a giant intracerebral varix associated with a high-flow pial AVF. This patient was treated by surgery and postoperative CT angiography showed extinction of AVF completely. The third case was an 8-year-old girl with a family history of HHT. She presented with gradual progression of paraparesis, sensory disturbance in the bilateral lower extremities and bladder dysfunction. MRI disclosed a perimedullary AVF with a large varix at the L3/4 level. The AVF was successfully interrupted by transarterial embolization with platinum coils. Post-embolization DSA showed complete disappearance of the AVF. The existence of HHT must always be considered a possibility when AVF of the CNS is diagnosed.
Sasamori
Toru
T
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, North-15 West-7, Kita-ku, Sapporo 060-8638, Japan.
Hida
Kazutoshi
K
Asano
Takeshi
T
Nakayama
Naoki
N
Kuroda
Satoshi
S
Iwasaki
Yoshinobu
Y
D000328:Adult; D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D003952:Diagnostic Imaging; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007223:Infant; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D019635:Neurosurgical Procedures; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000175:diagnosis / Q000235:genetics*; D014656:Vascular Surgical Procedures