Case Report : Hemorrhagic Acquired Pial Arteriovenous Fistula Occurring after Mechanical Thrombectomy : A Case Report

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  • Shindo Koichiro
    Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
  • Ogino Tatsuya
    Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
  • Fuchizaki Tomoki
    Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
  • Endo Hideki
    Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
  • Maruga Yohei
    Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
  • Watanabe Toshiichi
    Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
  • Kamiyama Kenji
    Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
  • Osato Toshiaki
    Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
  • Nakamura Hirohiko
    Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan

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タイトル別名
  • Hemorrhagic Acquired Pial Arteriovenous Fistula Occurring after Mechanical Thrombectomy: A Case Report

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<p>Objective: We report a patient in whom thrombectomy for occlusion of the middle cerebral artery was performed, and a pial arteriovenous fistula (AVF) developed in the relevant vascular area.</p><p>Case Presentation: The patient was a 72-year-old male. In 2011, thrombectomy with a Penumbra system for right M1 occlusion causing right cerebral infarction was performed. Recanalization was achieved (modified thrombolysis in cerebral infarction [TICI] 2b) although occlusion of the M2 anterior trunk remained. After 1 week, MRA confirmed complete recanalization. The course was favorable, and he was discharged. After 5 years, convulsion occurred, and he was brought to our hospital by ambulance. MRI showed subcortical hemorrhage of the right precentral gyrus. DSA confirmed an arteriovenous (AV) shunt between the right central artery and vein of Trolard, which had not been present. There was no nidus, leading to a diagnosis of a pial AVF. Under craniotomy, the shunt point was disconnected.</p><p>Conclusion: Intraoperative findings suggested the involvement of cortical vein thrombosis after thrombectomy in the etiology.</p>

収録刊行物

  • 脳神経血管内治療

    脳神経血管内治療 13 (2), 66-71, 2019

    特定非営利活動法人 日本脳神経血管内治療学会

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