Dural arteriovenous fistula after craniotomy for pilocytic astrocytoma in a patient with protein S deficiency

Section of Neurosurgery, Department of Surgery and Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.
Surgical Neurology (Impact Factor: 1.67). 08/2002; 58(1):59-64; discussion 64. DOI: 10.1016/S0090-3019(02)00730-9
Source: PubMed


We report an unusual case, which may provide insight into the etiology and pathogenesis of dural arteriovenous malformation.
A 24-year-old woman presented with hemorrhage into a pilocytic astrocytoma of the collicular plate. Angiography was normal and the tumor was surgically resected. She developed sigmoid sinus thrombosis and a transverse/sigmoid sinus dural arteriovenous fistula 11 months after this and was found to have protein S deficiency. The fistula was not treated. Angiography 4 years later was unchanged.
This report illustrates an acquired etiology of a dural arteriovenous fistula. To our knowledge this is the first reported case of postoperative sigmoid sinus thrombosis along with arteriovenous fistula in a patient with previously undetected protein S deficiency.

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