title: Multiple intracranial aneurysms associated with multiple dural arteriovenous fistulas and cerebral arteriovenous malformation.
abstract: BACKGROUND
  The association between intracranial aneurysms and arteriovenous malformations (AVMs) or dural arteriovenous fistulas (DAVFs) has been well documented, and the changes in cerebral blood flow dynamics were thought to be one of the major causes. There has not been a report on intracranial aneurysms associated with multiple DAVFs and AVMs in the same patient.
  
  
  METHODS
  The authors report a unique case of multiple intracranial vascular pathologies, including 5 aneurysms, 2 DAVFs, and 1 AVM coexisting in a single patient. The patient presented with headache and left hemiparesis and was found to have 4 bilateral internal carotid aneurysms, 1 ruptured right pericallosal aneurysm, 2 frontoparietal DAVFs, and 1 right temporal AVM.
  
  
  RESULTS
  Endovascular coiling and Onyx embolization successfully occluded 4 aneurysms and both DAVFs. The patient remained asymptomatic at 1-year follow-up.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of a very rare case with a unique combination of cerebrovascular pathologies including multiple aneurysms, DAVFs, and 1 high-grade AVM. Analyzing the hemodynamic relationships of these concurrent lesions is essential to determine the hemorrhage risk of each lesion and the order of priority in management. Flow-related aneurysms with irregular morphology require early, aggressive treatment.
authors: Department of Neurosurgery, The Second Affiliated Hospital, Guangzhou Medical College, Guangzhou, People's Republic of China.
authors: Mingchang
authors: M
authors: Li
authors: Ning
authors: N
authors: Lin
authors: Jianwei
authors: J
authors: Wu
authors: Jianfeng
authors: J
authors: Liang
authors: Weiwen
authors: W
authors: He
mesh_terms: D017542:Aneurysm, Ruptured / Q000150:complications; D002340:Carotid Artery Diseases / Q000150:complications; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000601:surgery; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology; D057510:Endovascular Procedures; D006261:Headache / Q000209:etiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000601:surgery; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D019635:Neurosurgical Procedures / Q000379:methods; D010291:Paresis / Q000209:etiology; D015607:Stents; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome