Abstract:
A 36-year-old male presented to the Emergency Department with clinical symptoms of blurred vision of progressive onset of two years of evolution. The ophthalmological examination revealed the existence of bilateral papilledema. Using cranial computed tomography and magnetic resonance imaging, the presence of a right occipital pial arteriovenous malformation was certified. Arteriographically, pial arterial contributions dependent on the right middle cerebral artery and the right posterior cerebral artery were identified. Venous drainage was located at the level of the superior sagittal sinus. An associated right transverse sinus stenosis was also identified. The existence of secondary intracranial hypertension was corroborated by monitoring with an intracranial pressure sensor. An interventional procedure was carried out consisting of embolization of the arterial supplies of the lesion using Onyx®. The clinical-radiological findings after the procedure were favorable: the papilledema disappeared and complete exclusion of the malformation was achieved. A new intracranial pressure measurement showed resolution of intracranial hypertension. Subsequent regulated radiological controls showed complete exclusion of the malformation up to 5 years later.
摘要:
一名36岁的男性出现在急诊科,其临床症状为视力模糊,经过两年的进化。眼科检查显示存在双侧乳头水肿。使用头颅计算机断层扫描和磁共振成像,证实存在右枕叶动静脉畸形.动脉造影,确定了依赖于右侧大脑中动脉和右侧大脑后动脉的软脑膜动脉贡献。静脉引流位于上矢状窦水平。还确定了相关的右横窦狭窄。通过使用颅内压传感器进行监测,证实了继发性颅内高压的存在。使用Onyx®进行介入手术,包括栓塞病变的动脉供应。手术后的临床放射学发现是有利的:乳头水肿消失,畸形完全排除。新的颅内压测量显示颅内高压的分辨率。随后的放射学控制显示,直到5年后,畸形完全排除。