Surgical Management of Dural Arteriovenous Fistula After Craniotomy: Case Report and Review of Literature

Document Type

Article

Publication Date

5-1-2016

Publication Title

World Neurosurg

Abstract

BACKGROUND: Development of dural arteriovenous fistula (dAVF) with cortical venous drainage at the site of previous craniotomy is a rare manifestation of nontraumatic subarachnoid hemorrhage (SAH). The authors present a case of postcraniotomy dAVF formation and discuss plausible underlying mechanisms of fistula formation and treatment options as well as review the literature.

CASE DESCRIPTION: A 62-year-old man, who had undergone craniotomy 2 decades previously, presented with SAH. Workup revealed a low-flow dAVF with leptomeningeal venous drainage at the posterior margin of the craniotomy. Surgical resection of fistula was undertaken that resulted in cure.

CONCLUSIONS: Spontaneous SAH in patients with a previous history of an intracranial procedure (e.g., craniotomy, ventriculostomy) should prompt detailed imaging evaluation. In the absence of vascular disease, meticulous review of the angiogram must be undertaken to rule out dAVF at the procedure site and it should be treated definitively.

Medical Subject Headings

Central Nervous System Vascular Malformations; Craniotomy; Endovascular Procedures; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Subarachnoid Hemorrhage; Tomography Scanners, X-Ray Computed

PubMed ID

26844878

Volume

89

First Page

731.e7

Last Page

731.e11

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