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Treatment of a cerebral pial arteriovenous fistula in a patient with sickle cell disease-related moyamoya syndrome: case report.
- Source :
-
Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2015 Aug; Vol. 16 (2), pp. 207-11. Date of Electronic Publication: 2015 May 22. - Publication Year :
- 2015
-
Abstract
- Sickle cell disease (SCD) is an autosomal recessive hematological disorder, characterized by sickling of the red blood cells in response to a hypoxic stress and vaso-occlusive crises. It is associated with moyamoya-like changes on cerebral angiographic imaging in 43% of patients. Cerebral aneurysms, arteriovenous malformations, and dural arteriovenous fistulas (AVFs) have been described in association with SCD and moyamoya disease. However, the description of a pial AVF (pAVF) in a patient with SCD and/or moyamoya formation has not yet been reported. The authors present the case of a 15-year-old boy with SCD-associated moyamoya disease harboring a pAVF who developed a de novo venous aneurysm 8 months after undergoing indirect superficial temporal artery-middle cerebral artery (MCA) bypass that was complicated by bilateral ischemia of the MCA territory. The pAVF was successfully treated with transarterial embolization using Onyx. The authors describe the possible pathophysiological mechanisms and management strategies for this rare occurrence.
- Subjects :
- Adolescent
Aneurysm, Ruptured diagnosis
Aneurysm, Ruptured etiology
Aneurysm, Ruptured therapy
Embolization, Therapeutic
Humans
Intracranial Aneurysm diagnosis
Intracranial Aneurysm etiology
Intracranial Aneurysm therapy
Intracranial Arteriovenous Malformations etiology
Intracranial Arteriovenous Malformations physiopathology
Intracranial Arteriovenous Malformations therapy
Magnetic Resonance Imaging
Male
Middle Cerebral Artery surgery
Moyamoya Disease etiology
Pia Mater blood supply
Stroke diagnosis
Stroke etiology
Stroke therapy
Temporal Arteries surgery
Anemia, Sickle Cell complications
Intracranial Arteriovenous Malformations diagnosis
Moyamoya Disease surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1933-0715
- Volume :
- 16
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery. Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 26053963
- Full Text :
- https://doi.org/10.3171/2014.12.PEDS14486