TP HCMMs. Mai, 44 years old, often heard strange noises in her head, causing tinnitus and insomnia for more than 6 months. The doctor discovered a complex cerebral vascular malformation.
The results of magnetic resonance imaging of the brain and cerebral vessels at Tam Anh General Hospital in Ho Chi Minh City showed that Ms. Mai had a dural arteriovenous fistula in the right transverse sigmoid sinus, about 4×2 cm in size.
On April 12, BS.CK II Thi Van Ginger, Head of the Interventional Imaging Unit, Deputy Director of the Vascular Intervention Center, said that arteriovenous fistula is a condition in which the arteries and veins in the brain are abnormally connected. often. Damage affects the patient, causing symptoms of tinnitus and difficulty sleeping.
Ms. Mai was prescribed endovascular intervention to block the fistula. Dr. Ginger assessed that the pathology of dural arteriovenous fistula in the transverse sigmoid sinus is complicated because there are many arterial sources supplying blood into the fistula. With the support of the modern DSA digital subtraction angiography system, the doctor inserts a small needle into the femoral artery, threads a microcatheter along the blood vessels to the brain, accesses and uses specialized materials to clogging the fistula.
Ms. Mai’s magnetic resonance imaging (MRI) clearly shows the complex cerebral arteriovenous system. Image: Tam Anh General Hospital
During the intervention process, the doctor must ensure the correct selection of blood vessels, preserving the venous sinuses that drain blood to the heart without being clogged. Ms. Mai is awake throughout the intervention process and can discuss directly with the doctor if she feels uncomfortable or has a headache.
After intervention, the fistula was almost completely clogged. The patient has no tinnitus, is healthy, no longer worried about insomnia due to strange noises in the head, and is expected to be discharged from the hospital after a few days.
The team intervenes to block the patient’s fistula. Image: Tam Anh General Hospital
Tinnitus is a condition in which sounds are heard when there is no actual noise from the outside environment. There are many causes of tinnitus, including blood vessel abnormalities in the brain.
Dr. Nguyen Thi Minh Duc, Head of the Department of Neurology, Center for Neuroscience, said that currently, vascular abnormalities such as arteriovenous and venous fistulas in the brain can be easily detected thanks to cranial magnetic resonance imaging. Cerebral vessels do not require injection of magnetic contrast agent.
Magnetic resonance imaging can also detect many other diseases related to cerebral blood vessels such as cerebral aneurysms, cerebral artery stenosis, vascular variations or abnormal brain vein development. Thereby, doctors have plans to monitor and provide preventive treatment for patients.
