Systemic metastases from gallbladder carcinoma occur frequently, but involvement of the central nervous system is rare. We describe such a case in a 68-year-old female. Solitary brain metastasis from gallbladder carcinoma was completely removed 4 months after operation for the primary tumor. Planned chemotherapy was then given to prevent recurrence. She was leading a normal life 4 years later. Patients with solitary brain metastasis from gallbladder carcinoma can achieve a better outcome and longer survival after removal of the brain metastasis if there is no other metastasis.
Three cases of traumatic middle meningeal arteriovenous fistula are reported and 32 cases, including ours, reported in the literature are analyzed. In these 32 cases, the appearance of the arteriovenous fistula at angiography exhibited one of three different configurations: type 1, the middle meningeal vein shows a railway configuration; type 2, the middle meningeal vein shows a rod configuration; type 3, extravasation of contrast material and/or pseudoaneurysm are concomitant. In correlating the angiographic type and clinical course, the following tendencies were observed: the clinical course was good in type 1, fair in type 2 and poor in type 3, respectively.
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