Malformación arteriovenosa en la neurofibromatosis tipo I. Caso clínico y revisión de la literatura

Abstract

Neurofibromatosis type I may be accompanied by cerebrovascular complications, mainly stenosis or aneurysms and more rarely vertebral arteriovenous fistulas and malformations. We report the first case of a child, as far as we know, with neurofibromatosis type I and subarachnoid hemorrhage caused by rupture of an arteriovenous malformation. A 9 year old girl presented with the acute onset of a condition preceded by vomiting, deterioration in her level of consciousness and neck rigidity caused by subarachnoid and intraventricular hemorrhage. On angiography a right interpeduncular arteriovenous malformation was seen which arose from the right anterior choroid artery. The patient was admitted to the intensive care unit for stabilization of her condition, followed by surgical operation and good subsequent progress. We review the cerebrovascular complications associated with neurofibromatosis type I that have been described in the literature. Neurofibromatosis type I may be associated with cerebrovascular complications. The most frequent of these are occlusive or stenotic, isolated or with a vascular pattern of progressive cerebral artery occlusive disease of moyamoya type and aneurysms. Other rarer cerebrovascular complications include fistulas and arteriovenous malformations. The patient we report is the first case of vascular malformation in children associated with neurofibromatosis type I as far as we are aware.