Postoperative hyperperfusion in a patient with a dural arteriovenous fistula associated with intracerebral hemorrhage: a case report
Abe, E.; Tashima, A.; Nakano, T.; Fujiki, M.; Kobayashi, H.
No Shinkei Geka. Neurological Surgery 40(10): 887-894
2012
ISSN/ISBN: 0301-2603 PMID: 23045403 Document Number: 659338
A 60-year-old male complained of a severe headache and developed generalized convulsions. He was drowsy at the time of admission and a neurological examination revealed aphasia and right hemianopsia. Plain computed tomography (CT) revealed an intracerebral hematoma in the left occipital lobe. He was treated conservatively, the hematoma passed without increasing and his symptoms gradually improved. Angiography showed a dural arteriovenous fistula (dAVF) in the left occipital region, which was classified as type IV based on Cognard and a varix of the draining vein. He was treated with direct surgery and obliteration of the draining vein. The color of the red vein changed to blue after disconnection of the fistulas by electrocoagulation. However, he experienced aphasia and loss of memory 2 days after the operation. CT and MRI revealed no change, but postoperative I-IMP SPECT demonstrated temporal hyperperfusion in this region. The present report describes a case of transient hyperperfusion occurring after treatment for a dAVF associated with an intracerebral hemorrhage.