• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.153-158
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• 2001

Traumatic carotid-cavernous fistula is a rare complication of moderate to severe head injury. For the treatment of carotid-cavernous fistula, detachable balloon occlusion is the best method of choice. A 26 year old male patient was hurt with a left periorbital penetrating injury 20 years ago, and then left side exophthalmos, bruit and right hemiparesis developed 10 years later. We experienced the very rare case of direct carotidcavernous fistula with cavernous dural arteriovenous fistula. Brain MRIs and cerebral angiograms revealed that direct carotid-cavernous fistula was accompanied by cavernous dural arteriovenous fistula due to longstanding venous hypertension and development of collateral circulation. Detachable balloon occlusion and surgical internal carotid artery ligation were not enough to occlude fistular flow, so cavernous dural arteriovenous fistula embolization was necessary. The authors present a case of long-standing traumatic carotid-cavernous fistula with cavernous dural arteriovenous fistula, with review of the literature.

• Journal of Korean Neurosurgical Society
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• 제65권4호
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• pp.598-602
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• 2022

Development of de novo dural arteriovenous fistula (DAVF) at a different site after resolution of an initial DAVF, is rare. Here we report two cases, which we encountered in our hospital. A 68-year-old woman presented with pulsatile tinnitus on the left side. Cerebral angiography demonstrated a left anterior condylar confluence (ACC) DVAF and she underwent transvenous embolization. Four years after this treatment, she presented with tinnitus on the left side, and cerebral angiography revealed a right DAVF around the sinus of the lesser sphenoid wing. Another 69-year-old woman presented with left-sided orbital bruits, chemosis, and conjunctival hyperemia. Cerebral angiography showed left cavernous sinus (CS) DAVF, for which she underwent transvenous embolization for CS DAVF. One year later, she developed a left ACC and transverse-sigmoid sinus (TSS) DAVF.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.54-57
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• 2015

A 66-year-old woman presented with intermittent paraparesis and generalized tonic-clonic seizure. Cerebral angiography demonstrated dural arteriovenous fistula (AVF) involving superior sagittal sinus (SSS), which was associated with SSS occlusion on the posterior one third. The dural AVF was fed by bilateral middle meningeal arteries (MMAs), superficial temporal arteries (STAs) and occipital arteries with marked retrograde cortical venous reflux. Transfemoral arterial Onyx embolization was performed through right MMA and STA, but it was not successful, which resulted in partial obliteration of dural AVF because of tortuous MMA preventing the microcatheter from reaching the fistula closely enough. Second procedure was performed through left MMA accessed by direct MMA puncture following small decortications of cranium overlying the MMA using diamond drill one week later. Microcatheter could be located far distally to the fistula through 5 F sheath placed into the MMA and complete obliteration of dural AVF was achieved using 3.9 cc of Onyx.

• Journal of Korean Neurosurgical Society
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• 제57권2호
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• pp.127-130
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• 2015

A 59-year-old female presented with progressive right proptosis, chemosis and ocular pain. An imaging work-up including conventional catheter angiography showed a right-sided dural arteriovenous fistula of the cavernous sinus, which drained into the right superior petrosal sinus, right superior ophthalmic vein, and right inferior ophthalmic vein, and cortical venous reflux was seen via the right petrosal vein in the right posterior fossa. After failure of transvenous embolization, the patient underwent Gamma Knife radiosurgery (GKRS). At one month after GKRS, she developed increasing ocular pain and occipital headache. Repeat angiography showed partial obliteration of the fistula and loss of drainage via the superior and inferior ophthalmic veins with severe congestion, resulting in slow flow around the right cerebellar hemisphere. Prompt transarterial embolization relieved the patient's ocular symptoms and headache. We report on a case of paradoxical exacerbation of symptoms resulting from obstruction of the venous outflow after GKRS for treatment of a dural arteriovenous fistula of the cavernous sinus.

• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.168-170
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• 2014

Dural arteriovenous fistula (AVF) is very rare, acquired lesion that may present with intracranial hemorrhage or neurological deficits. The etiology is not completely understood but dural AVF often has been associated with thrombosis of the involved dural sinuses. To our knowledge, this is the first well documented intracranial hemorrhage case caused by dural AVF following microvascular decompression for hemifacial spasm. A 49-year-old male patient had left microvascular decompression of anterior inferior cerebellar artery via retrosigmoid suboccipital craniotomy. The patient was in good condition without any residual spasm or surgery-related complications. However, after 10 months, he suffered sudden onset of amnesia and dysarthria. Computed tomography and magnetic resonance imaging revealed the presence of dural AVF around the left transverse-sigmoid sinus. The dural AVF was treated with Onyx$^{(R)}$ (ev3) embolization. At the one-year follow up visit, there were no evidence of recurrence and morbidity related to dural AVF and its treatment. This case confirms that the acquired etiology of dural AVF may be associated with retrosigmoid suboccipital craniotomy for hemifacial spasm, even though it is an extremely consequence of this procedure.

• Journal of Korean Neurosurgical Society
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• 제45권3호
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• pp.199-202
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• 2009

We report the case of a 64-year-old man with dural arteriovenous fistula (DAVF) at right jugular foramen, presented as subarachnoid and intraventricular hemorrhage. The malformation was fed by only the neuromeningeal trunk of the right ascending pharyngeal artery and drained into the right lateral medullary veins craniopetally. Complete embolization was attained by selective transarterial glue injection, but patient showed lower cranial neuropathies. A 3-month follow-up angiogram still showed persistent fistula occlusion. Transarterial glue embolization is a feasible method, only if a transvenous access is not possible in case of single channel fistula.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.296-301
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• 2016

Dural arteriovenous fistula (DAVF) of the transverse sinus with ophthalmic manifestations in young children are rare. We reviewed two cases of direct AVF of the transverse sinus with ocular manifestations managed at our institution. The first, a 2.5 years old male child presented with left exophthalmos. Angiography revealed AVF between the occipital artery and the transverse sinus. The second, a 2 years old female child, complained of left exophthalmos. Imaging studies showed bilateral direct AVFs of the transverse sinus with bilateral dysmaturation of the sigmoid sinus. Transarterial embolization was done in both cases. Clinical and radiological follow up revealed complete cure. This report suggests that DAVF of the transverse sinus supplied by the external carotid branches can present with ophthalmic manifestations especially if there is distal venous stenosis or obliteration involving sigmoid sinus. Transarterial embolization using coils and liquid embolic agents could be safe and feasible to obliterate the fistula.

• 대한영상의학회지
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• 제84권2호
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• pp.489-497
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• 2023

두개내 경막 동정맥루는 모든 두개내 혈관 기형의 약 10%-15%를 차지하는 비정상적인 동정맥 단락이다. 대부분의 두개내 경막동정맥루는 단독형이며, 다른 부위에 여러 경막동정맥루가 있는 경우는 드물다. 여러 경막동정맥루에 대한 대부분의 증례 보고에서는 동기형 동정맥루를 기술하였고, 이시성 경막동정맥루에 대한 보고는 상대적으로 적다. 이에 저자들은 경막 동정맥루의 색전술 후 추적 영상에서 이시성 경막 동정맥루가 발견된 75세 여성의 증례를 보고 하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.276-280
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• 2015

Tentorial dural arteriovenous fistula (DAVF) is a rare vascular disease, which has high risk of intracranial hemorrhage. We present two cases of tentorial DAVF which were successfully treated with single trial of transarterial embolization using Onyx. We briefly reviewed the types of the tentorial DAVF and strategies of treatment.

• Journal of Korean Neurosurgical Society
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• 제49권4호
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• pp.222-225
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• 2011

Superior petrosal sinus (SPS) dural arteriovenous fistula (DAVF) is one of tentorial DAVFs with significant morbidity, which usually drains into the petrosal vein and its tributaries. Unless there is a connection with venous sinus, surgical obliteration is required. We present two cases of SPS DAVF which were successfully treated with the presigmold retrolabyrinthine approach.