scholarly journals Dural Arteriovenous Fistula within Superior Sagittal Sinus Wall with Direct Cortical Venous Drainage: A Systematic Literature Review

2021 ◽  
Author(s):  
Rajendra Chavan ◽  
Shreya Sethi ◽  
Harsha Sahu ◽  
Neeraj Rao ◽  
Shivani Agarwal
Keyword(s):  
Literature Review ◽  
Treatment Option ◽  
Systematic Literature Review ◽  
Superior Sagittal Sinus ◽  
English Literature ◽  
Venous Drainage ◽  
Sagittal Sinus ◽  
Complete Obliteration ◽  
Cortical Venous Drainage ◽  
Special Subgroup

AbstractDural arteriovenous fistulas (DAVFs) located within superior sagittal sinus (SSS) wall with direct cortical venous drainage are rare. They are also known as variant DAVF (vDAVF) and form a special subgroup of DAVFs. Their chance of presenting with aggressive features is high compared with transverse sigmoid sinus fistula. They drain directly into cortical veins (Borden type 3, Cognard type III and IV). A systematic English literature review of SSS vDAVF was made. Systematic literature review revealed a total of 31 published cases. These were commonly seen in male population, (24 males, 77.41%, 24/31). Average age of patients was 54 years. A total of 24 patients (77.41%, 24/31) had aggressive clinical presentations with 13 patients (41.93%, 13/31) having intracranial hemorrhages (ICH). Two patients had rebleeding (15.38%, 2/13). Middle portion of SSS was commonly involved (15 cases, 75%). A total of 25 (96.15%, 25/26) cases had patent SSS. Most of the fistulas were idiopathic (65.38%, 17/26), with trauma being a frequent etiological factor (26.92%, 7/26). Venous ectasia was seen in 19 patients (59.37%, 19/32). Middle meningeal arterial (MMA) supply was seen in all patients (100%, 26/26), with bilateral MMA supply in 21 cases (80.76%), and unilateral in 5 cases (19.23%). Twenty patients (62.50%, 20/32) received only endovascular treatment (EVT), while four patients had EVT followed by surgery (12.5%, 4/32). Transarterial route via MMA was the preferred treatment option (79.16%). Complete obliteration of fistulas was noted in all cases (100%, 30/30). No immediate complication was noted after EVT. As much as 92.30% patients showed good recovery. Thus, SSS vDAVF forms a special subgroup of DAVF, with aggressive presentation, and warrants urgent treatment. EVT is effective treatment option and can produce complete obliteration.

scholarly journals Endovascular management of complex superior sagittal sinus dural arteriovenous fistula

2019 ◽  
Vol 46 (Suppl_2) ◽  
pp. V11
Author(s):  
André Beer-Furlan ◽  
Krishna C. Joshi ◽  
Hormuzdiyar H. Dasenbrock ◽  
Michael Chen
Keyword(s):  
Dural Arteriovenous Fistula ◽  
Superior Sagittal Sinus ◽  
Venous Drainage ◽  
Endovascular Management ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Complete Obliteration ◽  
Cortical Venous Drainage ◽  
Transvenous Approach

Superior sagittal sinus (SSS) dural arteriovenous fistulas (DAVFs) are rare and present unique challenges to treatment. Complex, often bilateral, arterial supply and involvement of large volumes of eloquent cortical venous drainage may necessitate multimodality therapy such as endovascular, microsurgical, and stereotactic radiosurgery techniques. The authors present a complex SSS DAVF associated with an occluded/severely stenotic SSS. The patient underwent a successful endovascular transvenous approach with complete obliteration of the SSS. The authors discuss the management challenges faced on this case.The video can be found here: https://youtu.be/-rztg0_cBXY.

Interhemispheric Approaches to Arteriovenous Malformations: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (5) ◽  
pp. 637-637
Author(s):  
Vijay Agarwal ◽  
Daniel L Barrow
Keyword(s):  
Cerebral Artery ◽  
Arteriovenous Malformations ◽  
Anterior Cerebral Artery ◽  
Superior Sagittal Sinus ◽  
Venous Drainage ◽  
Sagittal Sinus ◽  
Complete Obliteration ◽  
Future Risk ◽  
Risk Of Hemorrhage ◽  
Neurologically Intact

Abstract We present 2 illustrative cases of interhemispheric approaches to right sided arteriovenous malformations (AVMs). The first patient is a healthy 54-yr-old female who presented with left-sided hearing loss and pulsatile tinnitus, and was neurologically intact. Imaging demonstrated a right sided interhemispheric AVM, fed by the anterior cerebral artery with superficial venous drainage to the superior sagittal sinus. The AVM was thought to be asymptomatic and the patient chose to have her AVM treated surgically to eliminate future risk of hemorrhage. We elected to approach this lesion via a contralateral interhemispheric approach to avoid retraction of the right hemisphere. Intraoperative angiogram demonstrated complete obliteration of the malformation and the patient was neurologically intact postoperatively. The second patient is a 41-yr-old healthy male who presented with progressive bifrontal headaches and was also neurologically intact. Imaging revealed a right interhemispheric AVM fed by the anterior cerebral artery and with superficial venous drainage to the superior sagittal sinus. Although the patient's headaches may have been related, the patient's decision to undergo surgical resection was primarily to eliminate future risk of hemorrhage. The difference with this patient was that imaging revealed the presence of two draining veins on the left side that would potentially be injured via a contralateral approach. As a result, we elected to approach this lesion ipsilaterally. Intraoperative angiogram showed complete obliteration of the malformation with intact venous drainage, and the patient was neurologically intact postoperatively. Contralateral vs ipsilateral interhemispheric approaches are compared and contrasted.

scholarly journals Study of Dural Arteriovenous Fistula Drains into Leptomeningeal Vein without Sinus Interposition

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 127-134 ◽  
Author(s):  
T. Kawaguchi ◽  
M. Nakatani ◽  
T. Kawano
Keyword(s):  
Emergency Treatment ◽  
Superior Sagittal Sinus ◽  
Venous Drainage ◽  
Craniocervical Junction ◽  
Sigmoid Sinus ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Cranial Fossa ◽  
Venous Ischemia

We evaluated dural arteriovenous fistulas (DAVF) drains into leptomeningeal vein (LMV) without the venous sinus interposition. This type of DAVF contained the extra-sinusal type DAVF and the DAVF with so-called pure leptomeningeal venous drainage (PLMVD). We studied 15 patients with DAVF that flows into LMVD without passing into the sinus. The subjects were 5 patients with DAVF in the anterior cranial fossa, 2 with DAVF in the tentorium cerebelli, and 3 with DAVF in the craniocervical junction as extra-sinusal type DAVF and 3 with DAVF in the transverse sigmoid sinus and 2 with DAVF in the superior sagittal sinus as DAVF with PLMVD. This type appears to take a very aggressive course. The arterial pressure of the shunt is directly applied to LMV, which causes bending and winding of the vein, eventually varices, inducing intracranial haemorrhage or venous ischemia in the LMV reflux area. Emergency treatment should be performed as soon as possible. Although it is recognized that interruption of the draining vein is very effective, treatment methods such as TAE, direct surgery, and g knife treatment, or their combinations should be carefully chosen for each case.

scholarly journals Embolization of a superior sagittal sinus dural arteriovenous fistula under intrasinus balloon protection: A case report

2015 ◽  
Vol 21 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Yongxin Zhang ◽  
Qiang Li ◽  
Qing-hai Huang
Keyword(s):  
Dural Arteriovenous Fistula ◽  
Superior Sagittal Sinus ◽  
Therapeutic Option ◽  
Venous Drainage ◽  
Endovascular Embolization ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Cerebral Venous Drainage ◽  
Balloon Protection

Endovascular embolization has evolved to become the primary therapeutic option for dural arteriovenous fistulas (DAVFs). While guaranteeing complete occlusion of the fistula orifice, the goal of DAVF embolization is also to ensure the patency of normal cerebral venous drainage. This paper describes a case of successful embolization of a complex DAVF in the superior sagittal sinus with a multistaged approach using a combination of transvenous and transarterial tactics. The strategies and techniques are discussed.

The pathophysiology of otitic hydrocephalus

1997 ◽  
Vol 111 (8) ◽  
pp. 757-759 ◽  
Author(s):  
A. Tomkinson ◽  
R. G. S. Mills ◽  
P. J. Cantrell
Keyword(s):  
Magnetic Resonance Imaging ◽  
Superior Sagittal Sinus ◽  
Venous Pressure ◽  
Venous Drainage ◽  
Mural Thrombus ◽  
Resonance Imaging ◽  
Subsequent Increase ◽  
Sagittal Sinus ◽  
Magnetic Resonance Imaging Mri ◽  
Cerebral Venous Pressure

AbstractThe pathophysiology of otitic hydrocephalus remains controversial. It has been argued that involvement of the superior sagittal sinus, by, at least, a mural thrombus is a necessary component of this disease.We present a case of otitic hydrocephalus where on magnetic resonance imaging (MRI) normal luminal and mural flow within the superior sagittal sinus is demonstrated. The presence of thrombus in the lateral venous sinus alone appears sufficient in this case to impede venous drainage of the intracranial contents into the neck and produce a rise in the cerebral venous pressure and a subsequent increase in the CSF pressure. The presence of a superior sagittal sinus mural thrombus is not required.

scholarly journals Spontaneous resolution of direct carotid-cavernous fistulas: case series and literature review

2018 ◽  
Vol 25 (1) ◽  
pp. 71-89 ◽  
Author(s):  
Prasert Iampreechakul ◽  
Wuttipong Tirakotai ◽  
Adisak Tanpun ◽  
Yodkhwan Wattanasen ◽  
Punjama Lertbusayanukul ◽  
...  
Keyword(s):  
Literature Review ◽  
Case Series ◽  
Venous Drainage ◽  
Spontaneous Resolution ◽  
Spontaneous Closure ◽  
Low Flow ◽  
Spontaneous Thrombosis ◽  
Ocular Manifestations ◽  
Complete Obliteration ◽  
Carotid Cavernous Fistulas

Spontaneous regression of direct carotid-cavernous fistulas (CCFs) is extremely rare. Most of the patients with direct CCFs are usually treated using endovascular techniques. Spontaneous obliteration of the direct fistulas probably results from thrombosis of the venous drainage and/or cavernous sinus. We report spontaneous closure of nine direct CCFs in nine patients. From literature review, we found another 37 patients with 43 fistulas due to spontaneous obliteration of bilateral lesions in six cases. There was no spontaneous closure in large-sized fistula. The factors associated with spontaneous thrombosis of the fistulas may be low-flow and small-sized fistula, hypotension, severe ocular manifestations, dissections or spasm of carotid artery, and increased intracranial pressure. Spontaneous healing of direct traumatic CCFs should be confirmed with cerebral angiography. Conservative treatment of direct CCFs should be carefully restricted in patients with normal vision or minimal visual impairment, and the patients must be monitored closely for any changes in visual function. Prompt endovascular treatment for complete obliteration of the fistula should be performed in patients with rapidly progressive visual loss. Venous thrombosis can still effect vision and rerouting towards cortical veins remains a concern. Because spontaneous resolution cannot be reliably predicted, the fistula then should be treated rather than waiting for spontaneous thrombosis.

Microsurgical anatomy of the venous drainage into the superior sagittal sinus

Neurosurgery ◽  
1989 ◽  
Vol 24 (4) ◽  
pp. 514???20 ◽  
Author(s):  
B T Andrews ◽  
M Dujovny ◽  
H G Mirchandani ◽  
J I Ausman
Keyword(s):  
Superior Sagittal Sinus ◽  
Venous Drainage ◽  
Microsurgical Anatomy ◽  
Sagittal Sinus
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