Open AccessGamma Knife radiosurgical treatment of a dural arteriovenous fistula with the feeding branches from the meningo-pituitary trunks of both internal carotid arteries
Author(s) -
А. С. Токарев,
В. А. Рак,
К. В. Грецких,
О. Л. Евдокимова,
О. А. Викторова
Publication year - 2020
Publication title -
nejrohirurgiâ
Language(s) - English
Resource type - Journals
eISSN - 2587-7569
pISSN - 1683-3295
DOI - 10.17650/1683-3295-2020-22-1-56-64
Subject(s) - medicine , embolization , radiosurgery , microsurgery , radiology , endovascular treatment , neurovascular bundle , carotid cavernous fistula , arteriovenous malformation , surgery , arteriovenous fistula , fistula , aneurysm , radiation therapy
Treatment strategies for dural arterio-venous fistulas (DAFs) include single or multimodal schemes, including microsurgery, endovascular transarterial or transvenous embolization, or stereotactic radiosurgery (SRS). In the scientific medical resources, only 9 cases of bilateral DAFs of the brain are described, which required surgical intervention, and 4 were treated with endovascular or microsurgical approach; SRS was used in 5 cases, of which in 4 cases with previous or subsequent endovascular embolization. We have presented a case of successful SRS with Gamma Knife of bilateral DAF from the branches of meningo-hypophyseal trunks from inner carotid arteries without preliminary embolization or surgical resection. The use of SRS with Gamma Knife is possible with low-flow DAFs, as well as a part of a multimodal strategy with high-flow DAFs, which requires further study.