Surgical treatment of a dural arteriovenous fistula in the superior petrosal sinus of an elderly patient with minimal suboccipital craniotomy: case report.
An 85-year-old woman presented with a dural arteriovenous fistula of the superior petrosal sinus manifesting as venous infarction of the cerebellum. Magnetic resonance imaging and angiography revealed right cerebellar swelling, venous engorgement, and an arteriovenous fistula in the superior petrosal sinus. Our initial attempt to obliterate the lesion through a transvenous endovascular approach failed, so we successfully treated the fistula via surgical interruption of the superior petrosal vein through a small suboccipital craniotomy. Careful examination of the pattern of venous drainage is important to determine surgical indications. This case indicates that minimally invasive open surgery can be effective even in an elderly patient.
Department of Neurosurgery and Stroke Unit, Kanto Medical Center, NTT EC, Tokyo, Japan. tkim-tky@umin.ac.jp
Toshikazu
T
Kimura
Masaaki
M
Shojima
Tomoyuki
T
Koizumi
Syunsuke
S
Fukaya
Yasumitsu
Y
Ichikawa
Akio
A
Morita
D000367:Age Factors; D000369:Aged, 80 and over; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000473:pathology; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D002526:Cerebellar Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D002531:Cerebellum / Q000098:blood supply / Q000503:physiopathology; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003392:Cranial Sinuses / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D009777:Occipital Bone / Q000033:anatomy & histology / Q000601:surgery*; D013525:Surgical Instruments; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods