title: Transarterial N-Butyl-2-cyanoacrylate Embolization of an Intraosseous Dural Arteriovenous Fistula Associated With Acute Epidural Hematoma: Technical Case Report.
abstract: BACKGROUND
  Intraosseous dural arteriovenous fistulae (DAVF) are rare, especially those with drainage into the diploic venous system. The clinical presentation depends on the location of the lesion. This is the first report of an intraosseous DAVF associated with acute epidural hematoma.
  
  
  METHODS
  A 25-year-old man presented with headache and nausea. Imaging of the brain revealed abnormal signals indicative of acute epidural hematoma in the right frontal convexity. Angiography demonstrated a DAVF in the region of the frontal bone. Right external carotid artery angiography showed that the DAVF was fed mainly by the right middle meningeal artery with drainage into diploic veins. Immediately after embolization of the middle meningeal and the distal internal maxillary artery with 17% N-butyl-2-cyanoacrylate, the shunt was completely occluded. The patient was discharged 4 days later without clinical complications.
  
  
  CONCLUSIONS
  Intraosseous DAVF can be treated by surgical resection or endovascular embolization. Curative treatment requires careful inspection of the angiographic architecture and microsurgical anatomy.
authors: Department of Neurosurgery, The University of Tokushima Graduate School, Tokushima, Japan.
authors: Shotaro
authors: S
authors: Yoshioka
authors: Kazuyuki
authors: K
authors: Kuwayama
authors: Junichiro
authors: J
authors: Satomi
authors: Shinji
authors: S
authors: Nagahiro
mesh_terms: D000328:Adult; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000628:therapy*; D002533:Cerebral Angiography; D004322:Drainage; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D005624:Frontal Bone / Q000473:pathology; D006407:Hematoma, Epidural, Cranial / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008438:Maxillary Artery / Q000473:pathology; D008576:Meningeal Arteries / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D004659:Enbucrilate