一名 1 型神经纤维瘤病患者因大量皮下血肿导致颞浅动脉外伤性动静脉瘘,促使其接受手术切除和血管内治疗。

Surgical neurology international Pub Date : 2024-08-16 eCollection Date: 2024-01-01 DOI:10.25259/SNI_471_2024
Yoshihiro Sato, Tomosato Yamazaki, Sho Hanai, Daisuke Watanabe, Noriyuki Kato, Takehiro Kasai, Alexander Zaboronok, Eiichi Ishikawa
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引用次数: 0

摘要

背景:神经纤维瘤病 1 型(NF-1)的特征通常是与血管脆弱性有关的血管紊乱,这可能导致不利的结果。在此,我们描述了一例并发巨大皮下血肿的 NF-1 病例,该血肿有造成视力损伤的风险,但快速减压和随后的微创方法使患者获得了良好的治疗效果:一名40岁的NF-1女性患者在轻微头部挫伤后出现左侧颞部巨大皮下血肿。住院四天后,血肿增大并严重压迫左眼,为了保护视力功能,她立即进行了血肿清除术。血肿清除后,数字减影血管造影术立即发现了颞浅动静脉瘘,并通过血管内手术进行了栓塞。她的视力得以保留,在整个随访过程中未发现出血复发:结论:手术清除血肿后再进行血管内治疗可有效保护视力功能。由于血管脆弱是 NF-1 患者的特征,因此应牢记血管并发症可能导致严重的临床后果。在某些NF-1病例中,血管异常的微创治疗可能更为可取。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traumatic arteriovenous fistula of the superficial temporal artery caused by massive subcutaneous hematoma prompting surgical removal and endovascular treatment in a patient with neurofibromatosis type 1.

Background: Neurofibromatosis type 1 (NF-1) is often characterized by vascular disorders related to vessel vulnerability that can lead to unfavorable outcomes. Here, we describe a case of NF-1 complicated with a massive subcutaneous hematoma posing a risk of visual impairment for which rapid decompression and a subsequent less invasive approach result in a favorable outcome.

Case description: A 40-year-old woman with NF-1 presented with a massive left subcutaneous temporal hematoma following a mild head contusion. Four days after hospitalization, the hematoma increased in size and severely compressed the left eye, prompting immediate hematoma removal to preserve visual function. Immediately after the hematoma removal, a superficial temporal arteriovenous fistula was found on the digital subtraction angiography and embolized by the endovascular procedure. Her visual acuity was preserved, and no bleeding recurrence was observed throughout the follow-up.

Conclusion: Surgical hematoma removal followed by endovascular treatment was effective in preserving visual function. Since vessel fragility is characteristic of patients with NF-1, it should be kept in mind that vascular complications may lead to serious clinical outcomes. In certain NF-1 cases, less invasive treatments for vascular abnormalities may be preferable.

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