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Titolo:
Resection of a giant intracranial dural arteriovenous fistula with the useof low-flow deep hypothermic cardiopulmonary bypass after partial embolization: Technical case report
Autore:
Dufour, H; Levrier, O; Bruder, N; Messana, T; Grisoli, F;
Indirizzi:
Univ Marseille, Dept Neurosurg, Marseille, France Univ Marseille Marseille France ille, Dept Neurosurg, Marseille, France Univ Marseille, Dept Intervent Neuroradiol, Marseille, France Univ Marseille Marseille France ntervent Neuroradiol, Marseille, France Univ Marseille, Dept Cardiac Surg, Marseille, France Univ Marseille Marseille France e, Dept Cardiac Surg, Marseille, France Univ Marseille, Dept Neuroanesthesia, Marseille, France Univ Marseille Marseille France Dept Neuroanesthesia, Marseille, France
Titolo Testata:
NEUROSURGERY
fascicolo: 6, volume: 48, anno: 2001,
pagine: 1381 - 1385
SICI:
0148-396X(200106)48:6<1381:ROAGID>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
CIRCULATORY ARREST; ANEURYSMS; SURGERY;
Keywords:
cardiopulmonary bypass; chiari malformation; circulatory arrest; dural arteriovenous fistula; giant aneurysm; hypothermia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
11
Recensione:
Indirizzi per estratti:
Indirizzo: Dufour, H Hop Timone Adultes, Serv Neurochirurg, Rue St Pierre, F-13385 Marseille, France Hop Timone Adultes Rue St Pierre Marseille France F-13385 rance
Citazione:
H. Dufour et al., "Resection of a giant intracranial dural arteriovenous fistula with the useof low-flow deep hypothermic cardiopulmonary bypass after partial embolization: Technical case report", NEUROSURGER, 48(6), 2001, pp. 1381-1385

Abstract

OBJECTIVE AND IMPORTANCE: To describe the surgical resection of a giant intracerebral arteriovenous fistula with involvement of dura mater and surrounding bone. Intraoperative bleeding was controlled by hypothermic circulatory arrest. CLINICAL PRESENTATION: This 46-year-old woman complained of persistent headache for 1 year; her diagnostic workup revealed the presence of an arteriovenous fistula in the dura mater of the left temporal region fed by the meningeal artery of the external and internal carotid arteries, with normal run-off into Labbe's and Trolard's veins. Magnetic resonance imaging depicteda Chiari I malformation that was most likely a result of insufficient cerebral venous drainage. INTERVENTION: In preparation for surgery, staged embolization of feeders from the left meningeal artery and the left occipital artery was performed under controlled hypotension. This procedure failed to achieve a significantreduction in flow because of the immediate recruitment of internal branches of the internal carotid artery and dural branches of the right external carotid artery. Surgical treatment was undertaken without further embolization. Because of involvement of surrounding bone and the high risk of uncontrollable bleeding, the procedure was carried out with the patient under deephypothermic cardiopulmonary bypass. Forty-five minutes of low flow (1.5 L/min) at 18 degreesC allowed total resection of the involved dura mater and surrounding bone. Postoperative recovery was marked by left brain edema that disappeared within 10 days. findings on follow-up angiography were normal, and the patient was discharged with no neurological deficit. CONCLUSION: Low-flow deep hypothermic cardiopulmonary bypass can be used to control intraoperative bleeding for surgical excision of a giant intracerebral dural arteriovenous fistula.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 03:40:36