A cavernous sinus dural arteriovenous fistula treated by direct puncture of the superior ophthalmic vein with craniotomy: illustrative case

Katsuma Iwaki, Koichi Arimura, Shunichi Fukuda, Soh Takagishi, Keisuke Ido, Ryota Kurogi, Kenichi Matsumoto, Akira Nakamizo, Koji Yoshimoto

研究成果: ジャーナルへの寄稿学術誌査読

抄録

BACKGROUND The authors report a case of symptomatic cavernous sinus (CS) dural arteriovenous fistula (dAVF) that was successfully treated using direct puncture of the superior ophthalmic vein (SOV) with craniotomy. CS dAVF is commonly treated using transvenous embolization (TVE), with the most common access route via the inferior petrosal sinus (IPS). However, this route is sometimes unavailable because of an occluded, hypoplastic, aplastic, or tortuous IPS. The SOV is an alternative, albeit tortuous and long, route to the CS; therefore, direct SOV puncture is occasionally performed. Direct SOV puncture is mostly percutaneous; however, in this case, it was difficult because of subcutaneous SOV narrowing. OBSERVATIONS As the patient experienced increased intraocular pressure, decreased vision, and eye movement disorders, CS embolization was performed via direct puncture with a craniotomy because of other access difficulties. LESSONS Several reports have described CS dAVF in patients receiving endovascular treatment via direct SOV puncture using a transorbital approach. However, to the best of the authors’ knowledge, this is the first reported case of a CS dAVF treated using TVE with craniotomy. This approach is useful when the SOV cannot be reached intravenously and its distance from the epidermis is long.

本文言語英語
論文番号CASE23464
ジャーナルJournal of Neurosurgery: Case Lessons
6
20
DOI
出版ステータス出版済み - 11月 1 2023

!!!All Science Journal Classification (ASJC) codes

  • 臨床神経学
  • 外科

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