Rupture of a de novo dural AV fistula following adult cerebral AVM resection

2021 ◽  
Vol 14 (12) ◽  
pp. e246758
Author(s):  
Evan M Luther ◽  
Fatima Chagani ◽  
Hunter King ◽  
Robert Starke
Keyword(s):  
De Novo ◽  
Close Monitoring ◽  
Intracranial Arteriovenous Malformation ◽  
Arteriovenous Shunting ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Type Iv ◽  
Complete Obliteration ◽  
Intraparenchymal Haemorrhage ◽  
Repeat Angiography

Acquired unruptured dural arteriovenous fistulas (DAVFs) have been described; however, ruptured de novo DAVFs remain exceedingly rare. We describe the case of a man in his 40s who presented with a recurrent intraparenchymal haemorrhage several years after angiographic cure of an intracranial arteriovenous malformation (AVM). Repeat angiography identified a new Cognard type IV DAVF anterior to the prior craniotomy. He underwent preoperative embolisation followed by craniotomy to completely obliterate the fistulous point. This case illustrates the need for close monitoring of AVM patients, even after complete obliteration, as local recrudescence of arteriovenous shunting can occur even in adulthood.

scholarly journals Multiple Dural Arteriovenous Fistulas

2002 ◽  
Vol 8 (2) ◽  
pp. 183-191 ◽  
Author(s):  
A.J.P. Goddard ◽  
M.S. Khangure
Keyword(s):  
De Novo ◽  
Disease Process ◽  
Venous Drainage ◽  
Transverse Sinus ◽  
Dural Sinus ◽  
External Carotid ◽  
Unique Case ◽  
Arteriovenous Fistulas ◽  
Type Iv ◽  
Dural Arteriovenous Fistulas

Dural arteriovenous fistulas are most probably acquired lesions. However, they have been rarely encountered de novo. We present a unique case of a 71-year-old woman who initially presented with right-sided dural arteriovenous fistula (DAVF), which spontaneously resolved after diagnostic arteriography. She later developed asymptomatic occlusion of the left transverse sinus. Five years after her initial presentation she developed left-sided pulse-synchronous tinnitus. MRA and catheter angiography showed a complex type IV DAVF between the left transverse sinus and multiple dural branches arising from both left and right external carotid arteries. The left transverse sinus was isolated from the torcula herophili, with stenosis of the sigmoid sinus. Extensive cortical venous drainage was demonstrated. Endovascular cure was effected by polyvinyl alcohol particle and absolute alcohol occlusion of the dominant dural supply, and transvenous coil occlusion of the left transverse sinus. The patient's symptoms resolved almost immediately. This unique case demonstrates that dural sinus occlusion and DAVFs may co-exist, but there may not be a causal relationship. It is likely that both DAVFs and sinus occlusion are manifestations of the same disease process characterised by a pro-thrombotic state and secondary angiogenesis. It is important to recognise that changes in symptomatology, even long after apparent disappearance of a lesion may indicate recurrence, and careful follow up is advocated.

Metachronous spinal pial arteriovenous fistulas: case report

2020 ◽  
pp. 1-6
Author(s):  
Ramez N. Abdalla ◽  
Tahaamin Shokuhfar ◽  
Michael C. Hurley ◽  
Sameer A. Ansari ◽  
Babak S. Jahromi ◽  
...  
Keyword(s):  
Lower Extremity ◽  
De Novo ◽  
Vascular Lesion ◽  
Conus Medullaris ◽  
Perineal Pain ◽  
Conventional Angiography ◽  
Lower Extremity Weakness ◽  
Arteriovenous Fistulas ◽  
Type Iv ◽  
History Of

Spinal pial arteriovenous fistulas (spAVFs) are believed to be congenital lesions, and the development of a de novo spAVF has not been previously described. A 49-year-old female with a childhood history of vascular malformation–induced right lower-extremity hypertrophy presented in 2004 with progressive pain in her right posterior thigh and outer foot. Workup revealed 3 separate type IV spAVFs, which were treated by combined embolization and resection, with final conventional angiography showing no residual spinal vascular lesion in 2005. Ten years later, the patient returned with new right lower-extremity weakness, perineal pain, and left plantar foot numbness. Repeat spinal angiography demonstrated 2 de novo intertwined conus medullaris spAVFs.

scholarly journals Novel Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula

2021 ◽  
Author(s):  
Rasmiranjan Padhi ◽  
Sathish Kandasamy ◽  
Balasenthil Kumaran ◽  
Naci Kocer ◽  
Harshith Karmadhari
Keyword(s):  
Venous Drainage ◽  
Superior Ophthalmic Vein ◽  
Direct Puncture ◽  
Av Fistula ◽  
Third Nerve Palsy ◽  
Hypoglossal Canal ◽  
Arteriovenous Fistulas ◽  
Drainage Patterns ◽  
Complete Obliteration ◽  
Catheter Tip

Dural arteriovenous fistulas (DAVFs) are acquired pathological arteriovenous connections involving vessels that usually supply the meninges. A DAVF in the region of the hypoglossal canal is a rare form of fistula that involves the anterior condylar confluence or anterior condylar vein. We report a case of hypoglossal canal DAVF that was successfully embolized transvenously through a superior ophthalmic vein (SOV) approach. After failed attempts through jugular access, our patient was treated by a unique percutaneous direct puncture approach through the SOV, achieving complete obliteration of the fistula. A step-by-step description of the endovascular technique was described. The clinical course was uneventful without any new neurologic deficit. The eye symptoms and third nerve palsy had completely resolved at the 3-month follow-up visit. Hypoglossal canal DAVFs are rare and may exhibit complex venous drainage patterns. Knowledge of the complex venous anatomy is essential for planning an alternative transvenous route if the standard approach is not feasible. Xper CT (Philips Healthcare, Best, The Netherlands) is an excellent tool for identifying the exact site of the fistula as well as for confirming a safe position of the catheter tip for successful occlusion of this complex dural AV fistula.

Gamma Knife surgery for low-flow cavernous sinus dural arteriovenous fistulas

2010 ◽  
Vol 113 (Special_Supplement) ◽  
pp. 21-27 ◽  
Author(s):  
Hyun Ho Jung ◽  
Jong Hee Chang ◽  
Kum Whang ◽  
Jin Soo Pyen ◽  
Jin Woo Chang ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Cavernous Sinus ◽  
Transarterial Embolization ◽  
Gamma Knife Surgery ◽  
Low Flow ◽  
Close Monitoring ◽  
Arteriovenous Fistulas ◽  
Ocular Symptoms ◽  
Dural Arteriovenous Fistulas

Object The purpose of this study was to assess the efficacy of Gamma Knife surgery (GKS) for treating cavernous sinus dural arteriovenous fistulas (CSDAVFs). Methods Of the 4123 GKSs performed between May 1992 and March 2009, 890 procedures were undertaken to treat vascular lesions. In 24 cases, the vascular lesion that was treated was a dural arteriovenous fistula, and in 6 of these cases, the lesion involved the cavernous sinus. One of these 6 cases was lost to follow-up, leaving the other 5 cases (4 women and 1 man) to comprise the subjects of this study. All 5 patients had more than 1 ocular symptom, such as ptosis, chemosis, proptosis, and extraocular movement palsy. In all patients, CSDAVF was confirmed by conventional angiography. Three patients were treated by GKS alone and 2 patients were treated by GKS combined with transarterial embolization. The median follow-up period after GKS in these 5 cases was 30 months (range 9–59 months). Results All patients experienced clinical improvement, and their improvement in ocular symptoms was noticed at a mean of 17.6 weeks after GKS (range 4–24 weeks). Two patients received embolization prior to GKS but did not display improvement in ocular symptoms. An average of 20 weeks (range 12–24 weeks) was needed for complete improvement in clinical symptoms. There were no treatment-related complications during the follow-up period. Conclusions Gamma Knife surgery should be considered as a primary, combined, or additional treatment option for CSDAVF in selected cases, such as when the lesion is a low-flow shunt without cortical venous drainage. For those selected cases, GKS alone may suffice as the primary treatment method when combined with close monitoring of ocular symptoms and intraocular pressure.

scholarly journals Insights into the Genome Sequence ofChromobacterium amazonenseIsolated from a Tropical Freshwater Lake

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Alexandre Bueno Santos ◽  
Patrícia Silva Costa ◽  
Anderson Oliveira do Carmo ◽  
Gabriel da Rocha Fernandes ◽  
Larissa Lopes Silva Scholte ◽  
...  
Keyword(s):  
De Novo ◽  
Genomic Diversity ◽  
Protein Coding ◽  
Biotechnological Potential ◽  
Draft Assembly ◽  
Functional Studies ◽  
Alpha Hemolysin ◽  
Type Iv ◽  
Nudix Hydrolases ◽  
Colicin V

Members of the genusChromobacteriumhave been isolated from geographically diverse ecosystems and exhibit considerable metabolic flexibility, as well as biotechnological and pathogenic properties in some species. This study reports the draft assembly and detailed sequence analysis ofChromobacterium amazonensestrain 56AF. The de novo-assembled genome is 4,556,707 bp in size and contains 4294 protein-coding and 95 RNA genes, including 88 tRNA, six rRNA, and one tmRNA operon. A repertoire of genes implicated in virulence, for example, hemolysin, hemolytic enterotoxins, colicin V, lytic proteins, and Nudix hydrolases, is present. The genome also contains a collection of genes of biotechnological interest, including esterases, lipase, auxins, chitinases, phytoene synthase and phytoene desaturase, polyhydroxyalkanoates, violacein, plastocyanin/azurin, and detoxifying compounds. Importantly, unlike otherChromobacteriumspecies, the 56AF genome contains genes for pore-forming toxin alpha-hemolysin, a type IV secretion system, among others. The analysis of theC. amazonensestrain 56AF genome reveals the versatility, adaptability, and biotechnological potential of this bacterium. This study provides molecular information that may pave the way for further comparative genomics and functional studies involvingChromobacterium-related isolates and improves our understanding of the global genomic diversity ofChromobacteriumspecies.

Percutaneous Superselective Coil-Embolization of Intrarenal Arteriovenous Fistulas

1996 ◽  
Vol 37 (3P2) ◽  
pp. 539-541 ◽  
Author(s):  
H. Husstedt ◽  
A. Chavan ◽  
F. Ghadban ◽  
A. Leppert ◽  
M. Galanski
Keyword(s):  
Coil Embolization ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Percutaneous Catheter ◽  
Coil Occlusion ◽  
Av Fistulas ◽  
Small Parts

Purpose: To evaluate the role of percutaneous transcatheter coil-occlusion in the management of uncontrollable postoperative hematuria due to iatrogenic arteriovenous (AV) fistula. Material and Methods: In 2 patients, AV fistulas were occluded with percutaneous catheter-guided superselective coil embolization. Results: In both cases, occlusion of the AV fistulas was successful. Only small parts (less than 10%) of the parenchyma had to be sacrificed. No hypertension occurred. Conclusion: Percutaneous coil embolization is a useful alternative to surgery in cases of postoperative AV fistulas. Hematuria can be effectively controlled without resulting hypertension.

A de novo missense mutation in the gene encoding the SOX10 transcription factor in a Spanish sporadic case of Waardenburg syndrome type IV

2008 ◽  
Vol 146A (8) ◽  
pp. 1032-1037 ◽  
Author(s):  
Matías Morín ◽  
Antonio Viñuela ◽  
Teresa Rivera ◽  
Manuela Villamar ◽  
Miguel A. Moreno-Pelayo ◽  
...  
Keyword(s):  
Transcription Factor ◽  
Missense Mutation ◽  
De Novo ◽  
Sporadic Case ◽  
Syndrome Type ◽  
Waardenburg Syndrome ◽  
Gene Encoding ◽  
Type Iv

A variant of arteriovenous fistulas within the wall of dural sinuses. Results of combined surgical and endovascular therapy

1991 ◽  
Vol 74 (2) ◽  
pp. 199-204 ◽  
Author(s):  
Stanley L. Barnwell ◽  
Van V. Halbach ◽  
Christopher F. Dowd ◽  
Randall T. Higashida ◽  
Grant B. Hieshima ◽  
...  
Keyword(s):  
Venous Drainage ◽  
Venous Hypertension ◽  
Neurological Dysfunction ◽  
Dural Sinus ◽  
Unique Type ◽  
Content Type ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Av Fistulas ◽  
Cortical Venous Drainage

✓ Dural arteriovenous (AV) fistulas are thought to be acquired lesions that form in an area of thrombosis within a sinus. If the sinus remains completely thrombosed, venous drainage from these lesions occurs through cortical veins, or, if the sinus is open, venous drainage is usually into the involved sinus. Among 105 patients with dural A V fistulas evaluated over the the past 5 years, seven had a unique type of dural AV fistula in the superior sagittal, transverse, or straight sinus in which only cortical venous drainage occurred despite a patent involved sinus; the fistula was located within the wall of a patent dural sinus, but outflow was not into the involved sinus. This variant of dural AV fistulas puts the patient at serious risk for hemorrhage or neurological dysfunction caused by venous hypertension. Three patients presented with hemorrhage, one with progressive neurological dysfunction, one with seizures, and two with bruit and headaches. A combination of surgical and endovascular techniques was used to close the fistula while preserving flow through the sinus.

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