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Intracerebral atypical calcification in nongalenic pial arteriovenous fistula: a case report.

Tabatabai SA, Zadeh MZ, Habibi Z, Meybodi AT, Hashemi M - Cases J (2008)

Bottom Line: Nongalenic intradural arteriovenous fistulas, although uncommon, are clinically important.Choosing the appropriate therapeutic approach has been a controversial issue within the last decade.A 15-year-old male was presented with a calcified nongalenic arteriovenous fistula in the left parietal region, supplied by the left middle cerebral artery, and draining into the left lateral sinus.Although endovascular methods may be the treatments of choice in similar cases, in such huge calcified lesion, non-amenable to endovascular occlusion, open surgery seems to be preferred.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Imam Khomeini hospital, Tehran University of Medical Sciences, Tehran, Iran. zohreh_h56@yahoo.com.

ABSTRACT
Nongalenic intradural arteriovenous fistulas, although uncommon, are clinically important. Choosing the appropriate therapeutic approach has been a controversial issue within the last decade.A 15-year-old male was presented with a calcified nongalenic arteriovenous fistula in the left parietal region, supplied by the left middle cerebral artery, and draining into the left lateral sinus. The patient was managed surgically with traditional clipping the feeder artery, along with piecemeal resection of the huge calcified mass. Although endovascular methods may be the treatments of choice in similar cases, in such huge calcified lesion, non-amenable to endovascular occlusion, open surgery seems to be preferred.

No MeSH data available.


Related in: MedlinePlus

Noncontrast computed tomography showing a huge calcified egg-shaped mass. With a small adjacent calcified lesion (A) and a new episode of hemorrhage (B). CT-Angiography of the lesion (C). T1-weighted parasagittal (D) and T2-weighted coronal (E) magnetic resonance images reveal large mass lesion with signal void rim indicative of calcification and central hypersignal intensity due to met-hemoglobin deposition. Post-operative brain CT scan (F).
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Figure 1: Noncontrast computed tomography showing a huge calcified egg-shaped mass. With a small adjacent calcified lesion (A) and a new episode of hemorrhage (B). CT-Angiography of the lesion (C). T1-weighted parasagittal (D) and T2-weighted coronal (E) magnetic resonance images reveal large mass lesion with signal void rim indicative of calcification and central hypersignal intensity due to met-hemoglobin deposition. Post-operative brain CT scan (F).

Mentions: Brain computed tomography (CT) and magnetic resonance imaging (MRI) disclosed a huge (7.8 × 5.3 cm) intra-axial elliptical mass with a calcified margin in the left parietal region, causing a midline shift of 1 centimeter and containing hemorrhagic components of different ages (Figure 1). Four-vessel brain digital subtraction angiography (DSA) revealed an intradural nongalenic AVF and an associated varix, supplied from the left middle cerebral artery (MCA) and drained to the left lateral sinus just adjacent to the Torcular Herophili (Figure 2A and 2B). The left anterior cerebral artery (ACA) was not completely filled after dye injection, owing to high flow through the fistula.


Intracerebral atypical calcification in nongalenic pial arteriovenous fistula: a case report.

Tabatabai SA, Zadeh MZ, Habibi Z, Meybodi AT, Hashemi M - Cases J (2008)

Noncontrast computed tomography showing a huge calcified egg-shaped mass. With a small adjacent calcified lesion (A) and a new episode of hemorrhage (B). CT-Angiography of the lesion (C). T1-weighted parasagittal (D) and T2-weighted coronal (E) magnetic resonance images reveal large mass lesion with signal void rim indicative of calcification and central hypersignal intensity due to met-hemoglobin deposition. Post-operative brain CT scan (F).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2605763&req=5

Figure 1: Noncontrast computed tomography showing a huge calcified egg-shaped mass. With a small adjacent calcified lesion (A) and a new episode of hemorrhage (B). CT-Angiography of the lesion (C). T1-weighted parasagittal (D) and T2-weighted coronal (E) magnetic resonance images reveal large mass lesion with signal void rim indicative of calcification and central hypersignal intensity due to met-hemoglobin deposition. Post-operative brain CT scan (F).
Mentions: Brain computed tomography (CT) and magnetic resonance imaging (MRI) disclosed a huge (7.8 × 5.3 cm) intra-axial elliptical mass with a calcified margin in the left parietal region, causing a midline shift of 1 centimeter and containing hemorrhagic components of different ages (Figure 1). Four-vessel brain digital subtraction angiography (DSA) revealed an intradural nongalenic AVF and an associated varix, supplied from the left middle cerebral artery (MCA) and drained to the left lateral sinus just adjacent to the Torcular Herophili (Figure 2A and 2B). The left anterior cerebral artery (ACA) was not completely filled after dye injection, owing to high flow through the fistula.

Bottom Line: Nongalenic intradural arteriovenous fistulas, although uncommon, are clinically important.Choosing the appropriate therapeutic approach has been a controversial issue within the last decade.A 15-year-old male was presented with a calcified nongalenic arteriovenous fistula in the left parietal region, supplied by the left middle cerebral artery, and draining into the left lateral sinus.Although endovascular methods may be the treatments of choice in similar cases, in such huge calcified lesion, non-amenable to endovascular occlusion, open surgery seems to be preferred.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neurosurgery, Imam Khomeini hospital, Tehran University of Medical Sciences, Tehran, Iran. zohreh_h56@yahoo.com.

ABSTRACT
Nongalenic intradural arteriovenous fistulas, although uncommon, are clinically important. Choosing the appropriate therapeutic approach has been a controversial issue within the last decade.A 15-year-old male was presented with a calcified nongalenic arteriovenous fistula in the left parietal region, supplied by the left middle cerebral artery, and draining into the left lateral sinus. The patient was managed surgically with traditional clipping the feeder artery, along with piecemeal resection of the huge calcified mass. Although endovascular methods may be the treatments of choice in similar cases, in such huge calcified lesion, non-amenable to endovascular occlusion, open surgery seems to be preferred.

No MeSH data available.


Related in: MedlinePlus