A Case of Brainstem Arteriovenous Malformation Cured by Transvenous Embolization with Onyx

JNET Pub Date : 2019-10-21 DOI:10.5797/jnet.cr.2019-0036
Y. Tsuboi, Tomoaki Terada, H. Itokawa, S. Yamana, Michihisa Narikiyo, Norio Fujii, H. Nagasaki, Seiya Nagao, Chisaku Kambayashi
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引用次数: 0

Abstract

Objective: We report a case of ruptured brain stem arteriovenous malformation that was successfully treated by transvenous embolization in addition to transarterial embolization using Onyx. Case Presentation: A 61-year-old woman was admitted because of consciousness disorder following sudden-onset headache. CT revealed brain stem hemorrhage and MRI revealed abnormal vessels around the brainstem. Cerebral arteriovenous malformation on the right side of the pons was identified from an angiography. Her consciousness gradually improved from conservative treatment. Thereafter, endovascular treatment was performed. First, transarterial embolization with Onyx was performed to reduce the nidus as much as possible. Then, transvenous embolization for the remaining nidus was performed to completely embolize the cerebral arteriovenous malformation. No new neurological deficits were observed after treatment and no recurrence was noted on follow-up angiography 1 month after treatment. Conclusion: We treated the brainstem arteriovenous malformation using a combination of transvenous and transarterial embolizations. In suitable cases, transvenous embolization can be an alternative treatment for deep-seated cerebral arteriovenous malformations that are difficult to treat by transarterial embolization or direct surgery.
玛瑙经静脉栓塞治疗脑干动静脉畸形1例
目的:我们报告一例脑干动静脉畸形破裂的病例,该病例在使用Onyx经动脉栓塞的基础上,经静脉栓塞成功治疗。病例介绍:一位61岁的女性因突发性头痛后意识障碍入院。CT显示脑干出血,MRI显示脑干周围血管异常。脑桥右侧的脑动静脉畸形是通过血管造影术确认的。经过保守治疗,她的意识逐渐好转。之后,进行血管内治疗。首先,用玛瑙经动脉栓塞以尽可能减少病灶。然后,对剩余的病灶进行经静脉栓塞,以完全栓塞脑动静脉畸形。治疗后未观察到新的神经功能缺损,治疗后1个月随访血管造影术未发现复发。结论:我们采用经静脉和经动脉栓塞相结合的方法治疗脑干动静脉畸形。在合适的情况下,经静脉栓塞可以作为深部脑动静脉畸形的替代治疗方法,这些畸形难以通过动脉栓塞或直接手术治疗。
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来源期刊
自引率
0.00%
发文量
38
审稿时长
17 weeks
期刊介绍: JNET Journal of Neuroendovascular Therapy is the official journal of the Japanese Society for Neuroendovascular Therapy (JSNET). The JNET publishes peer-reviewed original research related to neuroendovascular therapy, including clinical studies, state-of-the-art technology, education, and basic sciences.
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