Embolización endovascular en hemorragia intraparenquimatosa temporo-occipital por fístula arteriovenosa pial: reporte de caso

Angely Palacios; Milton Yunga; Andrés Mercado; David Abril

doi:10.37711/rpcs.2023.5.1.397

Authors

Angely Palacios Universidad Católica de Cuenca https://orcid.org/0000-0002-3386-3908
Milton Yunga Universidad Católica de Cuenca, Cuenca, Ecuador. https://orcid.org/0000-0002-2629-8242
Andrés Mercado Universidad Católica de Cuenca, Cuenca, Ecuador. https://orcid.org/0000-0002-2436-2490
David Abril Universidad Católica de Cuenca, Cuenca, Ecuador. https://orcid.org/0000-0001-8585-095X

DOI:

https://doi.org/10.37711/rpcs.2023.5.1.397

Keywords:

Arteriovenous fistula, Case report, Intracranial arteriovenous malformations, Therapeutic embolization

Abstract

Cerebral arteriovenous malformations are an infrequent pathology, of which fistulous malformations are the least common. Surgical clinical management is not fully defined, so analyzing the efficacy of embolization in these patients is an important scientific contribution to society. A 28-year-old male patient with headache of 10/10 on the visual analog pain scale. Imaging studies were performed and showed intraparenchymal hemorrhage; computed tomography angiography revealed a ruptured cerebral arteriovenous malformation in the temporo-occipital region dependent on the middle cerebral artery; complex endovascular embolization was performed, with favorable results in his evolution. In conclusion, embolization as a treatment for hemorrhagic temporo-occipital arteriovenous malformation is a viable alternative in patients with stage IV on the Spetzler scale.

Downloads

Download data is not yet available.

References

Villarreal E. Malformaciones Arteriovenosas Cerebrales:

patrón temporal de ruptura y pronóstico clínico [Internet]. Monterrey: Universidad Autónoma de Nuevo

León; 2022 [Consultado 2022 Ago 16]. Disponible en:

http://eprints.uanl.mx/23024/7/23024.pdf

Ching-Jen Ch, Ding D, Derdeyn C, Lanzino G, Friedlander R, Southerland A, et al. Brain arteriovenous malformations. Neurology. [Internet]. 2020 Nov 17 [Consultado 2022 Sep 13]; 95(20): 917-927. doi: 10.1212/

WNL.0000000000010968

Ota T, Komiyama M. Pathogenesis of non-hereditary

brain arteriovenous malformation and therapeutic implications. Interv Neuroradiol. [Internet]. 2020

Jun [Consultado 2022 Sep 13]; 26(3): 244–253. doi:

1177/1591019920901931

Gallardo F, Martin C, Chang L, Diaz J, Bustamante J, Rubino P. Utilidad de las Escalas de Gradación en el Tratamiento Quirúrgico de Malformaciones Arteriovenosas

Cerebrales. Surg Neurol Int. [Internet]. 2019 [Consultado 2022 Sep 13]; 10(Suppl 1): S46–S57. doi: 10.25259/

SNI_454_2019

Cenzato M, Boeris D. Piparo M, Trends in Cerebrovascular

Surgery and Interventions. Acta Neurochirurgica Supplement. [Internet]. 2021 [Consultado 2022 Sep 13]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK573750/

Bai Y, He C, Zhang H, Ling F. De novo multiple dural

arteriovenous fstulas and arteriovenous malformation

after embolization of cerebral arteriovenous fstula:

case report. Childs Nerv Syst [Internet]. 2012 [Consultado 2022 Sep 23]. doi: 10.1007/s00381-012-1878-6

Voormolen M, Geens K, Van Den Hauwe L, Parizel P.

Spontaneous Closure of Cerebral Dural Arteriovenous

Fistulas with Direct Cortical Venous Drainage. Interv

Neuroradiol. [Internet]. 2009 Sep [Consultado 2022 Sep

. doi: 10.1177/159101990901500316

Stapf C, Labovitz D, Sciacca R, Mast H, Mohr J, Sacco R.

Incidence of Adult Brain Arteriovenous Malformation

Hemorrhage in a Prospective Population-Based Stroke

Survey. Cerebrovasc Dis [Intenet]. 2002 [Consultado

Sep 24]; 13: 43–46. doi:10.1159/000047745

Suárez J. Terapia endovascular cerebral en las malformaciones arteriovenosas. Invest Medicoquir [Internet].

[Consultado 2022 Sep 24]; 4(1): 12-19. Disponible

en: https://www.medigraphic.com/pdfs/invmed/cmq-

/cmq121c.pdf

Lara C, Narváez S. Caracterización Clínico - Epidemioló-

gica de la hemorragia subaracnoidea secundaria a malformaciones vasculares cerebrales en 3 hospitales de

quito PERÍODO 2014 – 2019 [Internet] Quito: Pontifcia

Universidad Católica del Ecuador; 2020 [Consultado

Sep 13]. Disponible en: http://repositorio.puce.

edu.ec/bitstream/handle/22000/18641/C.pdf?sequence=1&isAllowed=y

Zyck S, Sampath R. Arteriovenous Malformations. [Internet]. Treasure Island (FL): StatPearls Publishing; 2022

Ene [Consultado 2022 Oct 24]. Disponible en: https://

www.ncbi.nlm.nih.gov/books/NBK531479/

Cannizzaro D, Scibilia A, Frio F, Zaed I, Safa A, Cirillo L.

IV and V grade arteriovenous Malformations: A multicenter surgical experience. Use of multiple grading

system to predict surgical risk. J Clin Neurosci [Internet]. 2022 [Consultado 2022 Oct 24]; 104: 96-102. doi:

1016/j.jocn.2022.08.011

Spetzler R, Ponce F. 2011. A 3-tier classifcation of cerebral arteriovenous malformations. J Neurosurg [Internet]. 2011 [Consultado 2022 Oct 24]; 114: 842–849. Disponible en: https://doi.org/10.3171/2010.8.JNS10663

Syed A, Gohar J, Saher U, Syeda B, Manaal H, Syeda S,

et al. Role Of Radiosurgery In Arteriovenous Malformations. J Ayub Med Coll Abbottabad [Internet]. 2018

[Consultado 2022 Oct 24]; 30(3): 449-457. Disponible en:

https://jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/3598/2003

Zaki G, Zaki M, Zaki E. Transvenous embolization of arteriovenous malformations. [Internet]. 2019 [Consultado

Oct 28]. Disponible en: https://www.sciencedirect.

com/science/article/abs/pii/S030384671830341X?-

via%3Dihub