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        "titulo" => "Summary"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">We are presenting the case of a 63 year-old man with a dural arteriovenous malformation of the transverse sigmoid sinus who developed focal deficits followed by less localized symptoms such a disorientation&#44; lethargy and eventually comatose status&#46; Initial cerebral angiography showed retrograde filling of the cortical and deep cerebral venous system with marked delay in venous empting&#46; Following embolization clinical symptoms completely cleared at the time that control angiography showed retrograde venous flow turning anterograde&#46; Patient&#39;s symptoms recurred four months later when there was a relapse of retrograde cerebral venous drainage at the time he developed thrombosis of the superior longitudinal and right transverse sinuses&#46; Sinus thrombosis and thrombosis of the central retinal artery were coincidental with hypercoagulability rela-ted to hyperhomocysteinemia&#46; Since control angiography still showed persistence of the AV shunting radical excision of the involved dural sinuses was performed&#46; The final outcome was excellent&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The physiopathological mechanism responsible for neurological deficits in our patient most likely was ischemia of venous origin secondary to venous hyper-tension resulting from retrograde cerebral venous drainage&#46; The clinical and angiographic presenta-tion in few similar cases reported in the literature is reviewed&#46;</p>"
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        "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se presenta el caso de un hombre de 63 a&#241;os con una malformaci&#243;n arteriovenosa dural de la regi&#243;n del seno transverso-sigmoide que debut&#243; con s&#237;ntomas focales para desarrollar despu&#233;s d&#233;ficit de funciones superiores y finalmente estupor y coma&#46; La angiograf&#237;a cerebral inicial mostr&#243; drenaje venoso retrogrado hacia venas cerebrales corticales y profundas con un marcado retardo del tiempo angiogr&#225;fico&#46; Tras la pr&#225;ctica de embolizaci&#243;n transarterial los s&#237;ntomas revirtieron por completo&#44; al tiempo que la angiografia de control mostr&#243; una normalizaci&#243;n del drenaje venoso que se hizo anter&#243;grado&#46; Cuatro meses despu&#233;s los s&#237;ntomas recurrieron coincidiendo con la reaparici&#243;n de drenaje venoso cerebral retr&#243;grado cuando el paciente present&#243; trombosis del seno longitudinal superior&#44; del seno transverso-sigmoide derecho y de la arteria central de la retina en el contexto de hipercoagulabilidad secundaria a hiperhomocisteinemia&#46; La angiograf&#237;a cerebral de control mostr&#243; persistencia de f&#237;stula AV y drenaje venoso retr&#243;grado por lo que se procedi&#243; a resecar las estructuras durales implicadas&#44; logrando la curaci&#243;n definitiva&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El mecanismo fisiopatol&#243;gico responsable de los s&#237;ntomas en nuestro paciente fue probablemente isqu&#233;mico de origen venoso secundaria a la hipertensi&#243;n del sector venoso causada por la fistula AV dural&#46; Se revisa la presentaci&#243;n cl&#237;nica y angiogr&#225;fica en casos similares reportados en la literatura&#46;</p>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Palomino&#46; J&#46;C&#46;&#59; Lobato&#44; R&#46;D&#46;&#59; Campollo&#44; J&#46;&#59; Fern&#225;ndez-Alen&#44; J&#46;&#59; Lagares&#44; A&#46;&#58; Unruptured dural arteriovenous malformation of the transversesigmoid sinus presenting with focal symptoms and coma&#46; Neurocirug&#237;a 2004&#59; 15&#58; 458&#8211;467&#46;</p>"
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Más opciones de artículo
Unruptured dural arteriovenous malformation of the transverse-sigmoid sinus presenting with focal symptoms and coma
Malformación arteriovenosa dural del seno transverso-sigmoide no sangrante manifestada por síntomas focales y coma
J.C. Palomino
, R.D. Lobato, J. Campollo, J. Fernández-Alen, A. Lagares
Service of Neurosurgery and Section of Neuroradiology. Hospital “12 de Octubre”. Faculty of Medicine. University Complutense. Madrid

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