Abstract
Introduction
Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular lesion, and the literature is sparse. Most authors insist that simple disconnection of arteriovenous shunting is enough to treat intracral single-channel pial AVF in most cases, either by microsurgery or endovascular embolization without resection of entire vascular malformation.
Discussion
We report an insidious onset of peri-lesional edema formation after abrupt disconnection of AVF shunting with surgical arterial ligation. Treatment entailed anti-platelet and anti-coagulation agent to slow down thrombus formation in intracranial dual-channel pial AVF. We suggest that slowing down thrombus formation in the large varix with anti-platelet and/or anti-coagulation agents seems to be necessary in case of abrupt disconnection of shunting in intracranial single- or dual-channel pial AVF to prevent postoperative cerebral edema or infarction.
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Acknowledgment
This study was supported by a grant of Korea Healthcare Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A102065).
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Yang, J., Kwon, OK., Oh, C.W. et al. Surgical flow disconnection of cerebral pial dual-channel arteriovenous fistula with a large varix: the role of anti-platelet agent or anti-coagulation therapy. Childs Nerv Syst 29, 1021–1025 (2013). https://doi.org/10.1007/s00381-013-2025-8
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DOI: https://doi.org/10.1007/s00381-013-2025-8