Safety of Thrombolysis in a Patient with an Intracranial Dural Arteriovenous Fistula

  • Ana João Pissarra Medical Oncology Department, Hospital São Francisco Xavier, Lisbon, Portugal
  • Mariana Malheiro Medical Oncology Department, Hospital São Francisco Xavier, Lisbon, Portugal
  • Carolina Gouveia Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
  • Patrícia Vicente Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
  • Leonor Matos Medical Oncology Department, Hospital São Francisco Xavier, Lisbon, Portugal

Keywords

Pulmonary thromboembolism, thrombolysis, arteriovenous malformation

Abstract

Intracranial dural arteriovenous fistula is an abnormal connection between an artery and a vein that has an increased risk of bleeding. This case report presents a 53-year-old man diagnosed with a dural arteriovenous malformation fistula in occipital topography, lacking therapeutic indication because of an extension. He was admitted to an intensive care unit due to a high-risk pulmonary thromboembolism with indication for thrombolysis. Taking into account the hemorrhagic risk associated with arteriovenous malformation, the authors discuss the therapeutic options and the inherent risks.

References

  • Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galié N et al. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014;35:3033–3080.

  • Martin C, Sobolewski K, Bridgeman P, Boutsikaris D. Systemic thrombolysis for pulmonary embolism: a review. Pharm Ther 2016;41:770–775.

  • Smithburger PL, Campbell S, Kane-Gill SL. Alteplase treatment of acute pulmonary embolism in the intensive care unit. Crit Care Nurse 2013; 33:17–27.

  • Gandhi D, Chen J, Pearl M, Huang J, Gemmete JJ, Kahturia S. Intracranial dural arteriovenous fistulas: classification, imaging findings, and treatment. AJNR Am J Neuroradiol 2012;33:1007–1013.

  • Söderman M, Pavic L, Edner G, Holmin S, Andersson T. Natural history of dural arteriovenous shunts. Stroke 2008;39:1735–1739.

  • Daniels DJ, Vellimana AK, Zipfel GJ, Lanzino G. Intracranial hemorrhage from dural arteriovenous fistulas: clinical features and outcome. Neurosug Focus 2013;34:E15.

  • Konstantinides S, Tiede N, Geibel A, Olschewski M, Just H, Kasper W. Comparison of alteplase versus heparin for resolution of major pulmonary embolism. Am J Cardiol 1998;82:966–970.
  • Published: 2019-01-14

    Issue: LATEST ONLINE (view)

    Section: Articles

    How to cite:
    Pissarra, A., Malheiro, M., Gouveia, C., Vicente, P., & Matos, L. (2019). Safety of Thrombolysis in a Patient with an Intracranial Dural Arteriovenous Fistula. European Journal of Case Reports in Internal Medicine, 2. https://doi.org/https://doi.org/10.12890/2019_001019

    Most read articles by the same author(s)