けいれん発作にて発症した前頭蓋窩硬膜動静脈奇形の1例

抄録

Dural arteriovenous malformations are estimated to comprise 10 to 15% of all intracranial AVMs. They are predominantly located at the base of the skull, especially in the posterior cranial fossa, and transverse-sigmoid sinuses are usually involved. They also occur in the cavernous sinus. However, dural AVMs involving the anterior cranial fossa are rarely documented and most cases have intracranial hemorrhages, a great majority of which are intracerebral and/or subarachnoid. Cases with seizure attack are very rare. We have recently experienced one such rare case which, was operated on and cured completely.
We report a case of dural arteriovenous malformation in the anterior fossa with seizure attack. A 55-year-old male was hospitalized because of seizure attack. This attack was the first episode for this patient. MRI disclosed the curvilinear flow void in the left frontal pole. Angiography revealed an AVM in the anterior cranial fossa, fed by the left anterior ethmoidal artery and drained by the left olfactory vein. The draining vein without vascular sac finally reached the dural venous sinuses. The diagnosis of dural AVM was made. A left frontal craniotomy was performed. Removal of nidus was abandoned due to its deeply seated location in the olfactory groove, so coagulation of the nidus and resection of the drainer were performed. On postoperative angiography the dural AVM was not visualized any more. The patient showed no neurological deficit.