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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
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Delayed dural arteriovenous fistula after microvascular decompression for hemifacial spasm
Sung Han Kim1, Won Seok Chang1, Hyun Ho Jung1
1Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
Journal of Korean Neurosurgical Society
|October 21, 2014
Summary
A rare dural arteriovenous fistula (AVF) caused intracranial hemorrhage after surgery for hemifacial spasm. This case highlights a potential, though extremely rare, complication of microvascular decompression procedures.
Area of Science:
- Neurosurgery
- Vascular Neurology
Background:
- Dural arteriovenous fistulas (AVFs) are uncommon acquired vascular lesions.
- Their exact cause is often unclear, but they are frequently linked to dural sinus thrombosis.
Observation:
- A 49-year-old male developed amnesia and dysarthria 10 months post-microvascular decompression for hemifacial spasm.
- Imaging confirmed a dural AVF near the left transverse-sigmoid sinus.
Findings:
- This is the first documented case of intracranial hemorrhage from a dural AVF following microvascular decompression for hemifacial spasm.
- The dural AVF was successfully treated with Onyx embolization, with no recurrence at one-year follow-up.
Implications:
- Retrosigmoid suboccipital craniotomy for hemifacial spasm may be an acquired cause of dural AVF.
- This finding expands the understanding of dural AVF etiology and potential surgical complications.
