혈관내 색전술과 수술로 병합치료한 후두와-경추부 거대 경막내 척수주위 동정맥루 - 증례 보고 -
Management of Perimedullary Giant Arteriovenous Fistula(Type Ⅳc) by Embolization and Operative Ligation - Case Report -
소속 상세정보
김종태/Jong Tae Kim
고원일/이강운/최영근/백민우/김문찬/강준기/Won Il Ko/Young Geun Choi/Kang Woon Lee/Min Woo Bak/Mun Chan Kim/Joon Ki Kang
KMID : 0359819990280010114
Abstract
결론
이상과 같이 선택적 척수 혈관 조영술을 비롯한 여러 가지 신경방사선학적인 검사를 통한
척수주위 동정맥루의 정확한 진단과 혈관내 수술을 이용한 색전술과 또한 미세수술로서 경
추부에 발생한 거대 경막내 척수주위 동정맥루(Type Ⅳc)를 성공적으로 제거하였기에 문헌
고찰과 함께 보고하는 바이다.
#초록#
Intradural perimedullary arteriovenous fistulas(type Ⅳ spinal cord arteriovenous
malformations) that occur at cervical level are rarely reported in the literature.
A twelve year-old male patient was presented with suddenly developed progressing
quadriparesis. MR imaging and angiography demonstrated focal intramedullary hemorrage
at C5 vertebral level and intradural perimedullary arteriovenous fistula at C4 vertebral
level and ectatic endocranial venous drainage, fed by anterior spinal artery, radicular
branch of right vertebral artery, right thyrocervical trunk. The large draining vein
ascends toward and into the posterior fossa along route which was anterior to the lower
brain stem.
The initial treatment consisted of selective embolization of arterial feeders arising from
the right thyrocervical trunk and anterior spinal artery. The embolization procedures
were performed using GDC coil. Eight days after embolization, corpectomy was
performed at the C4-5 level and fistula ligation was done. Following these procedures,
the patient has progressively improved in motor and sensory function and post operative
angiogram revealed disappearance of fistula and abnormal endocranial venous drainage.
Spinal cord arteriovenous malformation; Perimedullary giant arteriovenous fistula; Endocranial drainage; Embolization; GDC coiling; Fistula ligation;
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