No shinkei geka. Neurological surgery
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We report a woman whose anterior communicating artery (AcomA) aneurysm was clipped via an anterior interhemispheric approach when she was 49 years old. At the age of 51, she presented with a subcutaneous abscess and osteomyelitis, so the cranioplastic bone was removed. Six months later, she underwent cranioplasty using hydroxyapatite. ⋯ A silicone T-tube was placed in the bifrontal epidural cavity (previous frontal sinus), and its tip was inserted into the nasal cavity through the nasofrontal duct for abscess drainage. After 3 months, the tube was removed. A CT scan acquired 10 years later showed no brain abscess, perifocal edema, or epidural and subcutaneous abscesses.
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We report a case of cavernous sinus dural arteriovenous fistula (dAVF) that developed after the treatment of a transverse-sigmoid sinus dAVF using transvenous embolization (TVE). ⋯ TVE has been widely recognized as an effective treatment for dAVF. However, dAVF may develop at a different location after TVE in a few cases. A long-term follow-up is therefore recommended.