• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.672-680
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• 2023

Objective : We evaluated the diagnosis, treatment, and long-term results of patients with dural arteriovenous fistula (dAVF), which is a very rare cause of posterior fossa hemorrhage. Methods : This study included 15 patients who underwent endovascular, surgical, combined, or Gamma Knife treatments between 2012 and 2020. Demographics and clinical features, angiographic features, treatment modalities, and outcomes were analyzed. Results : The mean age of the patients was 40±17 years (range, 17-68), and 68% were men (11/15). Seven of the patients (46.6%) were in the age group of 50 years and older. While the mean Glasgow coma scale was 11.5±3.9 (range, 4-15), 46.3% presented with headache and 53.7% had stupor/coma. Four patients (26.6%) had only cerebellar hematoma and headache. All dAVFs had cortical venous drainage. In 11 patients (73.3%), the fistula was located in the tentorium and was the most common localization. Three patients (20%) had transverse and sigmoid sinus localizations, while one patient (6.7%) had dAVF located in the foramen magnum. Eighteen sessions were performed on the patients during endovascular treatment. Sixteen sessions (88.8%) were performed with the transarterial (TA) route, one session (5.5%) with the transvenous (TV) route, and one session (5.5%) with the TA+TV route. Surgery was performed in two patients (14.2%). One patient (7.1%) passed away. While there were nine patients (64.2%) with a Rankin score between 0 and 2, the total closure rate was 69.2% in the first year of control angiograms. Conclusion : In the differential diagnosis of posterior fossa hemorrhages, the differential diagnosis of dAVFs, which is a very rare entity, should be considered, even in the middle and elderly age groups, in patients presenting with good clinical status and pure hematoma. The treatment of such patients can be done safely and effectively in a multidisciplinary manner with a good understanding of pathological vascular anatomy and appropriate endovascular treatment approaches.

• Clinical and Experimental Pediatrics
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• 제51권12호
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• pp.1363-1367
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• 2008

해면 혈관종은 비교적 양성의 병변이며 다량의 뇌출혈을 일으키는 것은 드물어서 수술의 적응증에 대해 논란의 여지가 있다. 그러나 특히 소뇌 같은 후두와나 뇌간에서 발생한 해면 혈관종에서의 출혈은 제한된 공간으로 인해 비가역적인 뇌손상을 일으킬 수 있으며 이로 인해 사망한 경우도 보고되고 있어서 소뇌의 압박증상이 있으면 응급수술을 해야 한다. 병변으로부터 반복되는 출혈로 인해 뒷목 근육통으로 오인되었던, 소아에서는 드물게 소뇌에 생긴 해면 혈관종 1예를 보고하는 바이다.