Paradoxical exacerbation of symptoms with obstruction of the venous outflow after gamma knife radiosurgery for treatment of a dural arteriovenous fistula of the cavernous sinus

Journal of Korean Neurosurgical Society
Jun Kyeung KoChang Hwa Choi

Abstract

A 59-year-old female presented with progressive right proptosis, chemosis and ocular pain. An imaging work-up including conventional catheter angiography showed a right-sided dural arteriovenous fistula of the cavernous sinus, which drained into the right superior petrosal sinus, right superior ophthalmic vein, and right inferior ophthalmic vein, and cortical venous reflux was seen via the right petrosal vein in the right posterior fossa. After failure of transvenous embolization, the patient underwent Gamma Knife radiosurgery (GKRS). At one month after GKRS, she developed increasing ocular pain and occipital headache. Repeat angiography showed partial obliteration of the fistula and loss of drainage via the superior and inferior ophthalmic veins with severe congestion, resulting in slow flow around the right cerebellar hemisphere. Prompt transarterial embolization relieved the patient's ocular symptoms and headache. We report on a case of paradoxical exacerbation of symptoms resulting from obstruction of the venous outflow after GKRS for treatment of a dural arteriovenous fistula of the cavernous sinus.

References

Jan 1, 1994·Stereotactic and Functional Neurosurgery·J L Barcia-SalorioG Hernández
May 20, 1998·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·H J ChiouD H Pan
Jun 19, 2002·Clinical Oncology : a Journal of the Royal College of Radiologists·Suzanne O'LearyMatthias W R Radatz
Jul 27, 2002·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·John C FlickingerL Dade Lunsford
Nov 19, 2003·Neurologia Medico-chirurgica·Masanari OnizukaMasahiro Yonekura
Sep 20, 2005·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Hung-Chuan PanChi-Chang Clayton Chen
Jun 17, 2006·Journal of Neurosurgery·Michael SödermanTommy Andersson
Dec 1, 2006·Journal of Neurosurgery·Hsiu-Mei WuShih-Jen Chen
Oct 25, 2008·Progress in Neurological Surgery·Yoshihisa Kida
Dec 9, 2010·Journal of Neurosurgery·Hyun Ho JungYong Gou Park
May 18, 2011·Neurosurgical Review·Ioannis LoumiotisMichael Link
Mar 14, 2013·Clinical Neurology and Neurosurgery·Richard T DalyaiPascal Jabbour
May 15, 2013·World Journal of Radiology·Bora KorkmazerOsman Kizilkilic

❮ Previous
Next ❯

Methods Mentioned

BETA
Gamma Knife

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.