Intracranial Pial Arteriovenous Fistula Caused by Dural Tenting: Case Report

• Published in: Neurologia medico-chirurgica Vol. 54; no. 3; pp. 242 - 244
• Main Authors: NISHIYAMA, Yoshihisa, KANEMARU, Kazuya, YOSHIOKA, Hideyuki, HANIHARA, Mitsuto, HORIKOSHI, Toru, KNIOUCHI, Hiroyuki
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 2014
• Subjects: Case Report; Central Nervous System Vascular Malformations - etiology; cerebral aneurysm; Cerebral Angiography; Cerebral Veins; Craniotomy; Dura Mater; dural tenting; Female; Fluorescein Angiography; Humans; Intracranial Aneurysm - surgery; Middle Aged; Pia Mater - blood supply; pial arteriovenous fistula; Postoperative Complications - diagnosis; Postoperative Complications - surgery; Reoperation; surgical complication
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.cr2012-0239

We describe a rare case where a patient developed intracranial pial arteriovenous (AV) fistula due to dural tenting. The patient was a 63-year-old woman who had undergone neck clipping for an unruptured middle cerebral artery (MCA) aneurysm. The surgery was performed without any problems and her postoperative course was uneventful. Two weeks after cerebral angiography operation revealed a pial AV fistula fed by the right MCA and drained into the vein of Trolard through the Sylvian vein which had not existed before surgery. Being diagnosed as de novo pial AV fistula, surgical repair was performed. The AV fistula was located just beneath the dural tenting. The fistulous point was confirmed with fluorescein video angiography and obliterated using a clip. Although rare, we should pay attention to the AV fistula due to dural tenting as the complications of cranial surgery.