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http://dx.doi.org/10.3340/jkns.2019.0233

Endovascular Treatment of Traumatic Arteriovenous Fistula in Young Adults with Pulsatile Tinnitus  

Kim, Hyun Sik (Department of Neurosurgery, Hallym University Sacred Heart Hospital)
Song, Joon Ho (Department of Neurosurgery, Hallym University Sacred Heart Hospital)
Oh, Jae Keun (Department of Neurosurgery, Hallym University Sacred Heart Hospital)
Ahn, Jun Hyong (Department of Neurosurgery, Hallym University Sacred Heart Hospital)
Kim, Ji Hee (Department of Neurosurgery, Hallym University Sacred Heart Hospital)
Chang, In Bok (Department of Neurosurgery, Hallym University Sacred Heart Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.63, no.4, 2020 , pp. 532-538 More about this Journal
Abstract
Traumatic arteriovenous fistulas (AVFs) involving the external carotid artery are exceedingly rare in young adults. Since an AVF is the most common life-threatening cause for pulsatile tinnitus (PT), meticulous evaluation and treatment of patients with PT is crucial. Here, we present two traumatic AVF cases treated with coil embolization leading to no residual fistulous connections followed by an immediate and complete resolution of PT. A 20-year-old man developed left ear tinnitus three months after a traumatic brain injury involving the right temporal bone fracture. Cerebral angiography demonstrated an enlarged left middle meningeal artery (MMA) and a fistular point at the posterior branch of the MMA draining to the middle meningeal vein (MMV) and the left pterygoid plexus, suggesting an AVF. Another 18-year-old girl developed left tinnitus, left exophthalmos, and conjunctival injection 6 months after a traffic accident involving no demonstrable abnormal findings in the radiologic exam. Magnetic resonance angiography demonstrated a markedly dilated left MMA draining to the MMV, left cavernous sinus, and left superior ophthalmic vein. In both cases, coil embolization was performed with total obliteration of the fistular point.
Keywords
Arteriovenous fistula; Embolization; Tinnitus; Meningeal artery;
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