Lanzino G, Passacantilli E, Lemole GM, McDougall C, Spetzler RF. Scalp arteriovenous malformation draining into the superior sagittal sinus associated with an intracranial arteriovenous malformation: just a coincidence? Case report.
Neurosurgery 2003;
52:440-3; discussion 443. [PMID:
12535376 DOI:
10.1227/01.neu.0000043934.85424.a2]
[Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2002] [Accepted: 08/13/2002] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE AND IMPORTANCE
Recent experimental and clinical evidence suggests that hemodynamic changes in the venous system can induce the formation of new arteriovenous malformations (AVMs). In a rat model, increased venous pressure induces the formation of soft tissue and dural AVMs. We report a clinical observation that may support these data.
CLINICAL PRESENTATION
A 4-year-old boy with a midline scalp AVM draining into the superior sagittal sinus had an associated intracranial/parenchymal AVM. The cerebral AVM increased venous pressure in the superior sagittal sinus as revealed by angiography.
INTERVENTION
The scalp AVM was resected, and the intracranial AVM was treated by use of the gamma knife.
CONCLUSION
On the basis of reported experimental data and the morphological and hemodynamic characteristics in this patient's two lesions, we suggest that the scalp AVM might have been induced by hypertension in the superior sagittal sinus. This clinical observation supports the notion suggested by experimental studies that hemodynamic changes can induce the formation of associated AVMs.
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