Skull Base Osseous Arteriovenous Fistula—A Rare Clinical Entity: Case Report and Literature Review

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• 作者：Aneesh Mohimen ; ^{romianeesh@gmail.com} ; ^{romianeesh@outlook.com} ; Santhosh Kumar Kannath ; E.R. Jayadevan
• 关键词：Central retinal vein occlusion ; Osseous arteriovenous fistula ; Skull base arteriovenous fistula ; Transvenous embolization
• 刊名：World Neurosurgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：97
• 期：Complete
• 页码：760.e9-760.e12
• 全文大小：1497 K
• 卷排序：97

文摘

To describe a rare clinical entity of intraosseous skull base arteriovenous fistula managed with transvenous fistula embolization.Case PresentationA 57-year-old woman presented with complaints of headache and episodic tinnitus with progressive left-sided visual deterioration. Cross-sectional imaging of the head revealed multiple vascular channels in the sphenoid bone and in bilateral masticator spaces. Catheter angiography showed the presence of a large osseous arteriovenous fistula epicentered in the body of sphenoid and left pterygoid plates with arterial feeders from bilateral external carotid arteries and venous drainage into bilateral cavernous sinuses and the pterygoid venous plexus. She was managed by transvenous coil and liquid embolic agent (Squid 18) embolization of the venous sac with significant reduction of shunt. In the postprocedure period, the patient developed paradoxical worsening of symptoms due to central retinal vein occlusion.ConclusionsSkull base osseous fistulae are uncommon clinical entities and fistulae centered within the sphenoid bone are very rare. The aim of this report was to highlight management issues associated with such a case and review the available literature on the subject.