RESUMEN
We present the second known case of a dural arteriovenous fistula (DAVF) associated with a glomus jugulare tumour in a 66-year-old man and the first with a presenting symptom of pulsatile tinnitus. The tumour occluded the left internal jugular vein at the bulb. Our patient opted for monitoring, but the tinnitus progressed and became debilitating, prompting him to proceed with embolisation of the tumour. Angiography revealed a DAVF of the left transverse sinus with retrograde flow. Embolisation of 80% of the tumour did not relieve symptoms. The patient returned for embolisation of the DAVF. Occlusion of the DAVF achieved symptomatic relief. A quandary develops during a procedure when the surgeon discovers that another intervention could satisfy the patient, while the patient is under anaesthesia. The higher flow in the DAVF likely causes the tinnitus in those with a patent sigmoid sinus, and embolisation of the DAVF alone could achieve relief.
Asunto(s)
Malformaciones Vasculares del Sistema Nervioso Central/complicaciones , Tumor del Glomo Yugular/complicaciones , Acúfeno/etiología , Anciano , Malformaciones Vasculares del Sistema Nervioso Central/diagnóstico por imagen , Malformaciones Vasculares del Sistema Nervioso Central/terapia , Angiografía Cerebral , Embolización Terapéutica , Tumor del Glomo Yugular/diagnóstico por imagen , Tumor del Glomo Yugular/terapia , Humanos , Imagen por Resonancia Magnética , Masculino , Acúfeno/diagnóstico , Senos Transversos/diagnóstico por imagenRESUMEN
We present the case of a 72-year-old man with hemoptysis after a thoracic projectile injury, which occurred while mowing the lawn. Chest radiograph followed by a computed tomography angiogram revealed a metallic foreign body in the right middle lobe of the lung. The patient underwent a right anterolateral thoracotomy where the object was successfully retrieved. The patient had an uneventful postoperative recovery.
