Journal List > J Korean Endocr Soc > v.23(1) > 1003475

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Choi, Lee, Lee, Kang, Ryu, Kim, Lee, Hong, Kim, Kim, Yoo, Ihm, Choi, and Yoo: A Case of Unilateral Exophthalmos Caused by a Dural Arteriovenous Malformation in Thyroid-Associated Ophthalmopathy
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2008; 23(1): 51-55.

Published online: 20 February 2008

DOI: https://doi.org/10.3803/jkes.2008.23.1.51

A Case of Unilateral Exophthalmos Caused by a Dural Arteriovenous Malformation in Thyroid-Associated Ophthalmopathy

Sun Ryoung Choi, Seong Jin Lee, Hae Ri Lee, Jun Goo Kang, Ohk Hyun Ryu, Chul Sik Kim, Byung Wan Lee, Eun Gyung Hong, Hyeon Kyu Kim, Doo-Man Kim, Jae Myung Yoo, Sung-Hee Ihm, Moon Gi Choi, Hyung Joon Yoo

Department of Internal Medicine, College of Medicine, Hallym University, Korea.

Received 15 October 2007       Accepted 1 December 2007

Copyright © 2008 Korean Endocrine Society

Abstract

Thyroid-associated ophthalmopathy is associated with thyroid dysfunction, particularly Graves' disease, and is manifested as eye signs, including proptosis. In cases of unilateral exophthalmos with thyroid-associated ophthalmopathy, other causes such as orbital neoplasm, carotid-cavernous fistula, cavernous sinus thrombosis, and dural arteriovenous malformation (AVM) should be excluded. Dural AVM, an abnormal dural arteriovenous connection, is a rare neurovascular entity that mimics thyroid-associated ophthalmopathy. When eye involvement is unilateral or asymmetric, dural AVM can be considered in the differential diagnosis of thyroid-associated ophthalmopathy. A twenty-six year-old woman presented with unilateral exophthalmos in Graves' disease. By orbital magnetic resonance imaging and cerebral angiography, thyroid-associated ophthalmopathy and dural AVM were diagnosed. The unilateral exophthalmos improved after coil embolization of the dural AVM. In summary, we report the first case of a dural AVM with Graves' disease and thyroid-associated ophthalmopathy.

Keywords: dural arteriovenous malformation, exophthalmos, thyroid-associated ophthalmopathy

Figures and Tables

Fig. 1
Orbital MRI. Right exophthalmos, both extraocular muscle thickening and right retro-orbital vessel engorgement (arrow) are seen.
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Fig. 2
Cerebral angiography reveals dural arteriovenous malformation (AVM) without cortical venous reflex, so called type I AVM (arrows).
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Fig. 3
After selection of dural AVM, coil embolization was performed in abnormal vessel.
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