대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제65권3호
  • /
  • Pages.229-233
  • /
  • 2011
  • /
  • 1738-2637(pISSN)
  • /
  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지

혈우병 환자에서 생긴 두피내 동정맥기형의 직접 천자 색전술: 증례 보고

Direct Puncture Embolization of Scalp Arteriovenous Malformation in a Patient with Severe Hemophilia A: A Case Report

  • 이경미 (경희대학교 의과대학 경희의료원 영상의학과학교실) ;
  • 김의종 (경희대학교 의과대학 경희의료원 영상의학과학교실) ;
  • 박봉진 (경희대학교 의과대학 경희의료원 신경외과학교실) ;
  • 김건하 (성균관대학교 의과대학 삼성서울병원 영상의학과학교실)
  • Lee, Kyung-Mi (Department of Radiology, Kyung Hee University Hospital, Kyung Hee University, Graduate School of Medicine) ;
  • Kim, Eui-Jong (Department of Radiology, Kyung Hee University Hospital, Kyung Hee University, Graduate School of Medicine) ;
  • Park, Bong-Jin (Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University, Graduate School of Medicine) ;
  • Kim, Keon-Ha (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 발행 : 2011.09.01
⟨ 이전 논문 다음 논문 ⟩

초록

본 증례 보고는 혈우병 환자에서 생긴 두피내 동정맥기형에 관한 내용이다. 22세 남자가 오른쪽 두정엽 두피내에 위치하는 박동성의 종괴를 주소로 내원하였다. 디지털 감산 혈관조영술에서 오른쪽 두정엽 두피내에 동정맥기형이 관찰되었으며, 종괴는 측두엽 및 후두엽 동맥 및 여러개의 정맥으로 이루어져 있었다. 두피내 동정맥기형에 대해 직접 천자 색전술과 함께 수술적 제거를 시행하였으며, 색전술과 수술 전후로 혈액응고인자 8을 투여함으로써 성공적으로 동정맥기형을 제거할 수 있었다.

We present a case of scalp arteriovenous malformation (AVM) in a patient with severe hemophilia A. The 22-year-old man presented with a pulsatile right parietal scalp mass. Digital subtraction angiography revealed an AVM in the right parietal scalp, supplied by superficial temporal and occipital arteries that drained into multiple venous structures. We successfully performed direct puncture embolization followed by surgical resection of the scalp AVM in conjunction with supplemental infusion of coagulation factor VIII before, during and after the embolization and the operation.

키워드

참고문헌

  1. Fisher-Jeffes ND, Domingo Z, Madden M, de Villiers JC. Arteriovenous malformations of the scalp. Neurosurgery 1995;36:656-660; discussion 660 https://doi.org/10.1227/00006123-199504000-00003
  2. Bowen DJ. Haemophilia A and haemophilia B: molecular insights. Mol Pathol 2002;55:1-18 https://doi.org/10.1136/mp.55.1.1
  3. Nagasaka S, Fukushima T, Goto K, Ohjimi H, Iwabuchi S, Maehara F. Treatment of scalp arteriovenous malformation. Neurosurgery 1996;38:671-677; discussion 677 https://doi.org/10.1227/00006123-199604000-00007
  4. Jeong HS, Choi JY, Lee HJ, Kim TW, Kim MB, So YK, et al. Diagnosis and Treatment of Extracranial Arteriovenous Malformations in the Head and Neck Region. Korean J Otolaryngol-Head Neck Surg 2005;48:1136-1142
  5. Han MH, Seong SO, Kim HD, Chang KH, Yeon KM, Han MC. Craniofacial arteriovenous malformation: preoperative embolization with direct puncture and injection of n-butyl cyanoacrylate. Radiology 1999;211:661-666 https://doi.org/10.1148/radiology.211.3.r99jn07661
  6. Jeong HS, Baek CH, Son YI, Kim TW, Lee BB, Byun HS. Treatment for extracranial arteriovenous malformations of the head and neck. Acta Otolaryngol 2006;126:295-300 https://doi.org/10.1080/00016480500388950
  7. Widlus DM, Murray RR, White RI Jr, Osterman FA Jr, Schreiber ER, Satre RW, et al. Congenital arteriovenous malformations: tailored embolotherapy. Radiology 1988;169: 511-516 https://doi.org/10.1148/radiology.169.2.3175000
  8. Ryu CW, Whang SM, Suh DC, Kim SM, Jang YJ, Kim HJ, et al. Percutaneous direct puncture glue embolization of high-flow craniofacial arteriovenous lesions: a new circular ring compression device with a beveled edge. AJNR Am J Neuroradiol 2007;28:528-530
  9. Benndorf G, Kim DM, Menneking H, Klein M. Endovascular management of a mandibular arteriovenous malformation in a patient with severe hemophilia a. AJNR Am J Neuroradiol 2004;25:614-617