De novo multiple dural arteriovenous fistulas and arteriovenous malformation after embolization of cerebral arteriovenous fistula: case report

Eleven patients with so-called “vein of Galen aneurysms” are reported, six of whom presented with vein of Galen aneurysmal malformations (four with choroidal type and two with mural type malformations). The remaining five patients presented with vein of Galen aneurysmal dilatations secondarily due to an arteriovenous malformation in one patient, an arteriovenous fistula in another, dural arteriovenous fistulas in two patients, and a varix in another. Treatments for these patients were individualised with consideration given to the clinical manifestations and the angioarchitecture of their lesions. Endovascular Intervention played a critical role in the treatment of these vein of Galen aneurysms.

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De Novo Dural Arteriovenous Fistula on Draining Veins of Previously Treated Pial Arteriovenous Malformation: a Case Report.

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2021.105798 ◽

2021 ◽

Vol 30 (7) ◽

pp. 105798

Author(s):

Francesco Diana ◽

Luigino Tosatto ◽

Nicolò Haznedari ◽

Christian Commodaro ◽

Maria Ruggiero

Keyword(s):

Case Report ◽

Arteriovenous Malformation ◽

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

De Novo ◽

Previously Treated

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Microsurgical treatment of a posterior fossa arteriovenous malformation initially mistaken for a dural arteriovenous fistula: avoidance of near disaster

Neurosurgical Focus: Video ◽

10.3171/2020.10.focvid2047 ◽

2021 ◽

Vol 4 (1) ◽

pp. V7

Author(s):

Brian M. Howard ◽

Daniel L. Barrow

Keyword(s):

Arteriovenous Malformation ◽

Arteriovenous Fistula ◽

Posterior Fossa ◽

Arteriovenous Malformations ◽

Dural Arteriovenous Fistula ◽

Transvenous Embolization ◽

Arteriovenous Fistulas ◽

Fatal Hemorrhage ◽

Hemorrhagic Complications ◽

Dural Arteriovenous Fistulas

Many brain arteriovenous malformations (AVMs) derive dural blood supply, while 10%–15% of dural arteriovenous fistulas (dAVFs) have pial arterial input. To differentiate between the two is critical, as treatment of these entities is diametrically opposed. To treat dAVFs, the draining vein(s) is disconnected from feeding arteries, which portends hemorrhagic complications for AVMs. The authors present an operative video of a subtle cerebellar AVM initially treated as a dAVF by attempted embolization through dural vessels. The lesion was subsequently microsurgically extirpated. The authors show a comparison case of an AVM mistaken for a dAVF and transvenous embolization that resulted in a fatal hemorrhage.The video can be found here: https://youtu.be/eDeiMrGoE0Q

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De Novo Formation of Direct Arteriovenous Fistula Involving Anterior Communicating Artery Aneurysm in Remote Site from Prior Ruptured Arteriovenous Malformation in Pediatric Patient: Case Report and Review of Literature

World Neurosurgery ◽

10.1016/j.wneu.2019.02.209 ◽

2019 ◽

Vol 126 ◽

pp. 252-256 ◽

Cited By ~ 1

Author(s):

Ryan Johnson ◽

Torin Karsonovich ◽

Hamad Farhat ◽

Dimitrios Nikas

Keyword(s):

Case Report ◽

Arteriovenous Malformation ◽

Arteriovenous Fistula ◽

Pediatric Patient ◽

De Novo ◽

Artery Aneurysm ◽

Anterior Communicating Artery ◽

Review Of Literature ◽

Remote Site ◽

Patient Case

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Transarterial approach for selective intravenous coil embolization of a benign dural arteriovenous fistula

Journal of Neurosurgery ◽

10.3171/jns.2003.99.4.0775 ◽

2003 ◽

Vol 99 (4) ◽

pp. 775-778 ◽

Cited By ~ 6

Author(s):

Koji Tokunaga ◽

Krisztina Barath ◽

Jean-Baptiste Martin ◽

Daniel A. Rüfenacht

Keyword(s):

Case Report ◽

Arteriovenous Fistula ◽

Coil Embolization ◽

Dural Arteriovenous Fistula ◽

Venous Reflux ◽

Content Type ◽

Dural Sinuses ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Fine Print

✓ Transarterial particulate embolization is indicated for benign intracranial dural arteriovenous fistulas (DAVFs) that have no dangerous venous reflux. This treatment, however, does not cure these lesions. In this case report the authors describe a spontaneously occurring DAVF that was treated by implanting coils through a transarterial microcatheter into the affected venous channel. The channel was separate from the normal dural sinuses. The pathological architecture of the fistula and the usefulness of this approach are discussed.

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Rare case of dural arteriovenous fistula presenting by spontaneous acute subdural hematoma: A case report and review of literature

Vojnosanitetski pregled ◽

10.2298/vsp160522111g ◽

2020 ◽

Vol 77 (2) ◽

pp. 237-239

Author(s):

Jagos Golubovic ◽

Djula Djilvesi ◽

Tomislav Cigic ◽

Vladimir Papic ◽

Bojan Jelaca ◽

...

Keyword(s):

Case Report ◽

Arteriovenous Fistula ◽

Subdural Hematoma ◽

Rare Case ◽

Dural Arteriovenous Fistula ◽

Neurological Deficits ◽

Acute Subdural Hematoma ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Subdural Bleeding

Introduction. Dural arteriovenous fistulas represent pathological acquired bonds between the meningeal blood vessels (arteries) and drainage veins associated to them. These fistulas can vary in clinical presentations, from being asymptomatic to causing serious neurological deficits, depending mostly on the localization and size. Only one fourth of dural fistulas present themselves with intracranial bleeding. This hemorrhage is most frequently localized in subarachnoid space, occasionally intracerebrally, and seldom beneath the dura mater, ie subdurally. Case report. We presented a rare case of a patient with spontaneous acute subdural hematoma. After the initial treatment and consequent imaging methods, a diagnosis of a dural arteriovenous fistula was established. After the craniotomy for hematoma evacuation, the patient underwent an uneventful endovascular treatment. Despite the rarity of non-traumatic acute subdural hematoma caused by dural arteriovenous fistula, one should not overlook the possible pathogenesis and etiology in patients with spontaneous acute subdural hematoma. Even with the absence of the symptoms and signs of subdural bleeding, dural arteriovenous fistula, as a cause of it, should not be immediately ruled out. Conclusion. Despite the rarity of non-traumatic acute subdural hematoma being caused by dural arteriovenous fistulas, one should not immediately overlook the possible pathogenesis and etiology. Cautious approach is needed when treating such diseases even in the absence of typical symptoms.

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Assessing the rate, natural history, and treatment trends of intracranial aneurysms in patients with intracranial dural arteriovenous fistulas: a Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) investigation

Journal of Neurosurgery ◽

10.3171/2021.1.jns202861 ◽

2021 ◽

pp. 1-10

Author(s):

Isaac Josh Abecassis ◽

R. Michael Meyer ◽

Michael R. Levitt ◽

Jason P. Sheehan ◽

Ching-Jen Chen ◽

...

Keyword(s):

Natural History ◽

Arteriovenous Fistula ◽

Outcomes Research ◽

Intracranial Aneurysms ◽

Dural Arteriovenous Fistula ◽

Aneurysm Rupture ◽

External Carotid ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas

OBJECTIVE There is a reported elevated risk of cerebral aneurysms in patients with intracranial dural arteriovenous fistulas (dAVFs). However, the natural history, rate of spontaneous regression, and ideal treatment regimen are not well characterized. In this study, the authors aimed to describe the characteristics of patients with dAVFs and intracranial aneurysms and propose a classification system. METHODS The Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) database from 12 centers was retrospectively reviewed. Analysis was performed to compare dAVF patients with (dAVF+ cohort) and without (dAVF-only cohort) concomitant aneurysm. Aneurysms were categorized based on location as a dAVF flow-related aneurysm (FRA) or a dAVF non–flow-related aneurysm (NFRA), with further classification as extra- or intradural. Patients with traumatic pseudoaneurysms or aneurysms with associated arteriovenous malformations were excluded from the analysis. Patient demographics, dAVF anatomical information, aneurysm information, and follow-up data were collected. RESULTS Of the 1077 patients, 1043 were eligible for inclusion, comprising 978 (93.8%) and 65 (6.2%) in the dAVF-only and dAVF+ cohorts, respectively. There were 96 aneurysms in the dAVF+ cohort; 10 patients (1%) harbored 12 FRAs, and 55 patients (5.3%) harbored 84 NFRAs. Dural AVF+ patients had higher rates of smoking (59.3% vs 35.2%, p < 0.001) and illicit drug use (5.8% vs 1.5%, p = 0.02). Sixteen dAVF+ patients (24.6%) presented with aneurysm rupture, which represented 16.7% of the total aneurysms. One patient (1.5%) had aneurysm rupture during follow-up. Patients with dAVF+ were more likely to have a dAVF located in nonconventional locations, less likely to have arterial supply to the dAVF from external carotid artery branches, and more likely to have supply from pial branches. Rates of cortical venous drainage and Borden type distributions were comparable between cohorts. A minority (12.5%) of aneurysms were FRAs. The majority of the aneurysms underwent treatment via either endovascular (36.5%) or microsurgical (15.6%) technique. A small proportion of aneurysms managed conservatively either with or without dAVF treatment spontaneously regressed (6.2%). CONCLUSIONS Patients with dAVF have a similar risk of harboring a concomitant intracranial aneurysm unrelated to the dAVF (5.3%) compared with the general population (approximately 2%–5%) and a rare risk (0.9%) of harboring an FRA. Only 50% of FRAs are intradural. Dural AVF+ patients have differences in dAVF angioarchitecture. A subset of dAVF+ patients harbor FRAs that may regress after dAVF treatment.

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