Dural Arteriovenous Fistula With Sinus Thrombosis and Venous Reflux Presenting as Parkinsonism

✓ In this article, the authors present five cases of dural arteriovenous fistula (AVF) that developed in the transverse—sigmoid sinus 2 to 6 years after sacrifice of the sigmoid sinus because of tumor involvement. The original tumor was meningioma in two patients and neurinoma, glomus jugulare tumor, and ameloblastoma in one patient each. The involved sigmoid sinus was resected along with the tumor and ligated at the normal edge; all that remained of the sigmoid sinus was a small stump on the retrosigmoid portion. Serial angiography performed before and after tumor surgery revealed no abnormal arteriovenous communications or dural AVF in any of the cases. Although many reports have suggested that sinus thrombosis is a precipitating factor in the pathogenesis of dural AVFs, this has been difficult to verify because of the small number of cases in which serial angiography was performed before the development of a dural AVF. In all of the cases presented in this article, surgical resection of a dural AVF and histological examination were performed. Subintimal fibrous thickening was marked, and the sinus wall was found to contain many dural vessels. Organized thrombosis with neovascularization was seen in only two patients. These cases demonstrate that subintimal fibrous thickening and a hypertrophied sinus wall secondary to increased intrasinus pressure or sinus thrombosis occurring after sinus occlusion can provoke the development of a dural AVF within the course of a lifetime. Maintenance of intrasinus blood flow may be very important to prevent this late postoperative complication.

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Sinus thrombosis probably resulting from a dural arteriovenous fistula development in the superior sagittal sinus

Acta Neurochirurgica ◽

10.1007/s00701-003-0049-7 ◽

2003 ◽

Vol 145 (8) ◽

pp. 719-721 ◽

Cited By ~ 3

Author(s):

S. Shimizu ◽

S. Sato ◽

H. Iida ◽

T. Mitomi ◽

K. Fujii

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Superior Sagittal Sinus ◽

Sinus Thrombosis ◽

Sagittal Sinus

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“Loop-like formation” in the cortical venous reflux of dural arteriovenous fistula with intracranial hemorrhage

Journal of Neuroradiology ◽

10.1016/j.neurad.2013.11.005 ◽

2014 ◽

Vol 41 (5) ◽

pp. 316-321 ◽

Cited By ~ 1

Author(s):

Masaomi Koyanagi ◽

Nobuyuki Sakai ◽

Hidemitsu Adachi ◽

Yasushi Ueno ◽

Takeharu Kunieda ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Intracranial Hemorrhage ◽

Dural Arteriovenous Fistula ◽

Venous Reflux ◽

Cortical Venous Reflux

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Cerebral venous sinus thrombosis and dural arteriovenous fistula in a 75-year-old man primarily presenting with repeated transient visual obscurations

Rinsho Shinkeigaku ◽

10.5692/clinicalneurol.cn-000855 ◽

2016 ◽

Vol 56 (4) ◽

pp. 281-284

Author(s):

Takeo Sato ◽

Hiromasa Matsuno ◽

Shusaku Omoto ◽

Kenichi Sakuta ◽

Yuka Terasawa ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Venous Sinus ◽

Venous Sinus Thrombosis

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Dural Arteriovenous Fistula Caused by Sinus Thrombosis —Case Report—

Neurologia medico-chirurgica ◽

10.2176/nmc.34.543 ◽

1994 ◽

Vol 34 (8) ◽

pp. 543-546 ◽

Cited By ~ 11

Author(s):

Hajime TOUHO ◽

Hideyuki OHNISHI ◽

Takeki KOMATSU ◽

Norihiko FURUOKA ◽

Jun KARASAWA

Keyword(s):

Case Report ◽

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Sinus Thrombosis

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Abstract T P368: Subcortical Calcification on CT as Diagnostic Sign of Transverse-Sigmoid Dural Arteriovenous Fistula With Cortical Venous Reflux

Stroke ◽

10.1161/str.45.suppl_1.tp368 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Shunji Mugikura ◽

Takahiro Metoki ◽

Takaki Murata ◽

Noriko Kurihara ◽

Yasushi Matsumoto ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Clinical Symptoms ◽

Posterior Part ◽

Ct Scans ◽

Venous Reflux ◽

Specific Symptom ◽

Diagnostic Sign ◽

Cortical Venous Reflux ◽

Diagnostic Symptoms

Background: and purpose The annual mortality rate of the patients who had dural arteriovenous fistula (dAVF) with cortical venous reflux (CVR) is high without treatment and early diagnosis is considered desirable. However, diagnostic symptoms of dAVF with CVR are varied and sometimes non specific or chronic one such as tinnitus, headache, dizziness, dementia and so on, which causes of delay in diagnosis. We sought to determine the subcortical calcifications on computed tomography (CT) scans as the diagnostic sign of dAVF with CVR. Material and methods: In 119 consecutive patients diagnosed with dAVF by the cerebral angiographic findings, we reviewed for the prevalence of subcortical calcifications on CT, shunting sites and side of shunting and the presence of cortical venous reflux (CVR) on angiograms and clinical symptoms leading to the diagnosis (diagnostic symptoms). Results: Subcortical calcifications on CT scans were seen in 10 patients (8.4% of 119 patients with dAVF). All of them had dAVF of transverse-sigmoid sinus (TS-dAVF) with CVR. Prevalence of subcortical calcifications was significantly higher in patients with TS-dAVF (P<0.001) (21%, 10 of 48 patients) than in patients with other than TS-dAVF (0 of 71 patients), and significantly higher in patients with CVR (P<0.001) (19 %, 10 of 52 patients) than in patients without CVR (0%, 0 of 67 patients). Subcortical calcifications tended to limited in the posterior part of the same hemisphere as hemisphere with shunting and appeared to be curvilinear ones predominantly involving the cortico-medullary junction at the bottom of cerebral gyri. Prevalence of subcortical calcifications was significantly higher in patients with chronic or non specific symptom (P<0.001, 26 %, 8 of 31 patients) than those with acute or ophthalmic symptom (2%, 2 of 88 patients). Conclusion: Subcortical calcification on CT is a sign of TS-dAVF with CVR, specifically in patients who present chronic or non specific symptoms. Subcortical calcifications found in TS-dAVF could be caused by venous congestion due to long-lasting CVR without being noticed or diagnosed.

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