Spontaneous resolution of ruptured intracranial pial arteriovenous fistula following spinal surgery.
Pial arteriovenous fistulae (AVFs) are rare vascular abnormalities that are distinct from arteriovenous malformations and dural AVFs. These vascular lesions have been linked with trauma, ischemic syndromes, venous thrombotic diseases, and intracranial surgical procedures. In this report we describe a case of an intracranial ruptured pial AVF immediately following uneventful spinal surgery in an elderly patient with subsequent spontaneous resolution. He was a previous heavy smoker with a 60-pack-year history and alcohol abuse. His examination was positive for morbid obesity and mild weakness of the anterior tibialis and gastrocnemius muscles bilaterally. He underwent uneventful spinal surgery, suffering a generalized seizure shortly after extubation. Imaging studies demonstrated acute subarachnoid hemorrhage and cerebral angiography identified a pial AVF. He was stabilized medically and follow-up angiography demonstrated spontaneous resolution of the pial AVF. This case highlights a rare vascular malformation with rupture following uneventful spinal surgery.
Mayo Clinic in Arizona, USA.
Mark K
MK
Lyons
Mayo Clinic in Arizona, USA.
Joseph M
JM
Hoxworth
Mayo Clinic in Arizona, USA.
Jamal
J
McClendon
Mayo Clinic in Arizona, USA.
Chandan X
CX
Krishna
Mayo Clinic in Arizona, USA.
Naresh P
NP
Patel
D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000209:etiology*; D002533:Cerebral Angiography; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010841:Pia Mater / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000503:physiopathology*; D013122:Spinal Diseases / Q000601:surgery; D015898:Tomography Scanners, X-Ray Computed
Pial arteriovenous fistula; spine surgery; subarachnoid hemorrhage