Engorged medullary vein on CT angiography in patients with dural arteriovenous fistula: prevalence, types, and comparison between regional and extensive types

2018 ◽  
Vol 10 (11) ◽  
pp. 1114-1119
Author(s):  
Yen-Heng Lin ◽  
Chung-Wei Lee ◽  
Yu-Fen Wang ◽  
Chi-Ju Lu ◽  
Ya-Fang Chen ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Ct Angiography ◽  
Cerebral Hemisphere ◽  
Dural Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Demographic Data ◽  
Descriptive Analysis ◽  
Clinical Information ◽  
Clinical Findings ◽  
Cerebral White Matter

Background and purposeEngorged medullary vein (EMV) in patients with intracranial dural arteriovenous fistula (DAVF) suggests venous congestion. The aim of this study is to investigate its prevalence, pattern, and correlation with clinical findings.Materials and methodsCT angiography (CTA) raw data of DAVF were used for multiplanar reconstruction and then analyzed for the presence and pattern of EMV, which is defined as a dilated vein in the cerebral white matter. Patients with EMV were divided into two groups: regional and extensive. Regional type is defined as EMV limited to one cerebral hemisphere or cerebellum without evidence of subcortical calcification. Extensive type is defined as EMV involvement of more than one cerebral hemisphere or both the cerebrum and cerebellum. Descriptive analysis of clinical information, DAVF characteristics, and other imaging findings was conducted. Clinical information, including demographic data, clinical presentation, and hemorrhage, were correlated with both types of EMV.ResultsAmong 192 eligible patients with DAVF, 71 (37%) had EMV. Patients with EMV were older (63 years vs 56 years, P=0.02), with DAVF more often at the transverse and sigmoid sinus (P<0.001), and more often presented with aggressive symptoms (59% vs 34%, P=0.02) than non-EMV patients, but there was no difference in the presentation of hemorrhage (15% vs 16%, P=0.99). Patients with regional EMV had a higher proportion of hemorrhage than those with the extensive type (24% vs 0%, P=0.006).ConclusionsEMV in patients with DAVF is associated with an aggressive manifestation. Regional type EMV is associated with a higher risk of a hemorrhagic presentation.

Computer-Aided Diagnosis in Jaundice: Comparison of Knowledge-based and Probabilistic Approaches

1996 ◽  
Vol 35 (01) ◽  
pp. 41-51 ◽  
Author(s):  
F. Molino ◽  
D. Furia ◽  
F. Bar ◽  
S. Battista ◽  
N. Cappello ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Information ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Clinical Documentation ◽  
Data Set ◽  
Knowledge Based ◽  
Number Of Patients ◽  
Support Tools ◽  
Aided Diagnosis

AbstractThe study reported in this paper is aimed at evaluating the effectiveness of a knowledge-based expert system (ICTERUS) in diagnosing jaundiced patients, compared with a statistical system based on probabilistic concepts (TRIAL). The performances of both systems have been evaluated using the same set of data in the same number of patients. Both systems are spin-off products of the European project Euricterus, an EC-COMACBME Project designed to document the occurrence and diagnostic value of clinical findings in the clinical presentation of jaundice in Europe, and have been developed as decision-making tools for the identification of the cause of jaundice based only on clinical information and routine investigations. Two groups of jaundiced patients were studied, including 500 (retrospective sample) and 100 (prospective sample) subjects, respectively. All patients were independently submitted to both decision-support tools. The input of both systems was the data set agreed within the Euricterus Project. The performances of both systems were evaluated with respect to the reference diagnoses provided by experts on the basis of the full clinical documentation. Results indicate that both systems are clinically reliable, although the diagnostic prediction provided by the knowledge-based approach is slightly better.

Endovascular Treatment of an Intracranial Dural Arteriovenous Fistula with Spinal Venous Drainage

1998 ◽  
Vol 4 (3) ◽  
pp. 241-246 ◽  
Author(s):  
R. Cruz ◽  
A. Stocker ◽  
J. Xavier ◽  
J. Almeida-Pinto
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Venous Drainage ◽  
Hyperintense Signal ◽  
Type V ◽  
Progressive Paraparesis ◽  
T2 Weighted Images

A case of type V intracranial dural arteriovenous fistula (DAVF) is reported because of its unusual rapidly progressive paraparesis. Despite this clinical presentation, the diagnosis of DAVF was made and precocious endovascular treatment was instituted. Angiographic normalization was obtained after embolisation and the patient significantly improved within the first weeks, although at the six month control MRI there still was a hyperintense signal of the cord in T2 weighted images, but less extensive than originally.

Galenic dural arteriovenous fistula: unusual clinical presentation and successful endovascular therapy

2002 ◽  
Vol 97 (2) ◽  
pp. 467-470 ◽  
Author(s):  
John B. Weigele ◽  
John C. Chaloupka ◽  
Walter S. Lesley
Keyword(s):  
Magnetic Resonance ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Magnetic Resonance Images ◽  
Interstitial Edema ◽  
Content Type ◽  
Clinical Recovery ◽  
Structural Abnormalities ◽  
Fine Print

✓ The authors report a case in which the clinical and neuroimaging findings were initially considered diagnostic of a brainstem glioma. Angiography revealed a deep venous system (galenic) dural arteriovenous fistula causing brainstem interstitial edema. Successful endovascular surgery resulted in complete clinical recovery of the patient and resolution of the structural abnormalities that had been observed on magnetic resonance images. The neuroimaging and therapeutic significance of this case are discussed.

scholarly journals WITHDRAWN: Trans-arterial CT angiography for surgical planning of spinal dural arteriovenous fistula

2020 ◽  
pp. 100715
Author(s):  
Saminderjit Kular ◽  
George Tse ◽  
Alexandru Budu ◽  
Andrew Bacon ◽  
Kishor A. Choudhari ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Ct Angiography ◽  
Surgical Planning ◽  
Dural Arteriovenous Fistula ◽  
Spinal Dural Arteriovenous Fistula

Cervical Spine Dural Arteriovenous Fistula With Coexisting Spinal Radiculopial Artery Aneurysm Presenting as Subarachnoid Hemorrhage

Neurosurgery ◽  
2011 ◽  
Vol 70 (1) ◽  
pp. 259-263 ◽  
Author(s):  
Joshua W. Lucas ◽  
Jesse Jones ◽  
Azadeh Farin ◽  
Paul Kim ◽  
Steven L. Giannotta
Keyword(s):  
Native American ◽  
Cervical Spine ◽  
Subarachnoid Hemorrhage ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Artery Aneurysm ◽  
Sudden Onset ◽  
Spinal Dural Arteriovenous Fistula ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE We present a patient with a cervical spine dural arteriovenous fistula associated with a radiculopial artery aneurysm at the same vertebral level presenting with subarachnoid hemorrhage. CLINICAL PRESENTATION A 45-year-old Native American man presented with sudden-onset severe headache, lethargy, and right hemiparesis. Computed tomography (CT) of the head showed subarachnoid hemorrhage and hydrocephalus. A subsequent CT of the neck showed an anterior spinal subdural hematoma from C2 to C4 causing mild cord compression. Carotid and vertebral angiography failed to demonstrate an intracranial aneurysm, but showed a spinal dural arteriovenous fistula originating from the right vertebral artery at the C5 neuroforamen. The severity of the patient's symptoms, atypical for rupture of a dural arteriovenous fistula, prompted more thorough angiographic evaluation. Thus, injection of the right thyrocervical trunk was performed, demonstrating a 4-mm spinal radiculopial artery aneurysm. Following ventriculostomy, a hemilaminectomy from C4 to C7 was performed with disconnection of the fistula from its drainage system. Subsequent resection of the aneurysm, which was determined to be the cause of the hemorrhage, was accomplished. The patient improved neurologically and was discharged to rehabilitation. CONCLUSION Spinal cord aneurysms from a separate vascular distribution may coexist with spinal dural arteriovenous fistulas. In the setting of spinal hemorrhage, especially in situations with an atypical clinical presentation, comprehensive imaging is indicated to rule out such lesions.

Angiographically occult spinal dural arteriovenous fistula located using selective computed tomography angiography

2007 ◽  
Vol 7 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Taku Sugawara ◽  
Yoshitaka Hirano ◽  
Yasunobu Itoh ◽  
Hiroyuki Kinouchi ◽  
Satoshi Takahashi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Spinal Cord ◽  
Mr Imaging ◽  
Arteriovenous Fistula ◽  
Ct Angiography ◽  
Dural Arteriovenous Fistula ◽  
Low Flow ◽  
Spinal Dural Arteriovenous Fistula ◽  
Coronary Veins ◽  
Spinal Arteriovenous Malformation

✓Spinal dural arteriovenous fistula (DAVF) is the most common type of spinal arteriovenous malformation and may cause progressive myelopathy but is usually treatable in the early stages by direct surgery or intravascular embolization. Selective spinal angiography has been the gold standard for diagnosis, but angiographically occult DAVF is not uncommon. A 67-year-old man presented with a 2-year history of progressive paraparesis. Magnetic resonance (MR) imaging demonstrated segmental atrophy of the spinal cord and dilated coronary veins on the dorsal surface of the spinal cord. A DAVF was suspected, but repeated selective angiography failed to demonstrate the fistula. Findings from spoiled gradient echo MR imaging suggested that the draining vein flowed into the dilated venous plexus at the T-9 level. Selective computed tomography (CT) angiography of the right T-9 intercostal artery confirmed the location of the fistula. The authors successfully occluded the draining vein through surgery, and they observed that the fistula was low flow. The patient exhibited improvement in his symptoms, and postoperative MR imaging confirmed closure of the fistula. Selective CT angiography is useful in locating the draining vein of angiographically occult DAVF and therefore minimizing the extent of the surgical procedure.

scholarly journals Computed tomography (CT) angiography with multidetector row helical CT for detecting spinal dural arteriovenous fistula

2008 ◽  
Vol 48 (3) ◽  
pp. 205-207 ◽  
Author(s):  
Hiroshi Kobessho ◽  
Shigeru Mitsui ◽  
Hiroyuki Ishihara ◽  
Masahiko Fujii ◽  
Ryota Kawasaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Arteriovenous Fistula ◽  
Ct Angiography ◽  
Dural Arteriovenous Fistula ◽  
Helical Ct ◽  
Spinal Dural Arteriovenous Fistula ◽  
Multidetector Row

Perfusion Computed Tomography in a Dural Arteriovenous Fistula Presenting With Focal Signs

Neurosurgery ◽  
2010 ◽  
Vol 66 (1) ◽  
pp. E226-E227 ◽  
Author(s):  
Alfonso Lagares ◽  
José María Millán ◽  
Ana Ramos ◽  
José A.F. Alén ◽  
Jesús Hernández Gallego
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Cerebral Blood Volume ◽  
Clinical Presentation ◽  
Venous Drainage ◽  
Hyperintense Lesion ◽  
Transient Time ◽  
Perfusion Computed Tomography

Abstract OBJECTIVE To describe the use of perfusion computed tomography (PCT) in the study of hemodynamic disturbances associated with a case of a cerebral dural arteriovenous fistula (DAVF) with leptomeningeal venous drainage presenting with focal signs. CLINICAL PRESENTATION A 79-year-old man presented because of loss of strength in the right arm. On examination, he presented mild right-side hemiparesis. Magnetic resonance imaging showed the presence of a left frontoparietal hyperintense lesion on T2-weighted images. Magnetic resonance angiography and digital substraction angiography (DSA) showed a convexity Borden type III DAVF. The DAVF was embolized with bucrylate, and control DSA showed complete obliteration of the malformation. The patient improved from his clinical presentation and 6 months after treatment was asymptomatic. TECHNIQUE Perfusion computed tomography was performed before and after treatment. All imaging studies were performed on a 6-slice spiral computed tomography scanner. Each series studied a 2.4-cm slide of brain at the level of the cerebral convexity where the DAVF was located. Quantitative perfusion data were obtained from significant regions of interest of both hemispheres, and an interhemispheric ratio (IR) was calculated. Pretreatment PCT showed an increase in mean transient time (IR = 2.2) and time to peak (IR = 1.15), with an increase in cerebral blood volume (IR = 1.9) in the left frontal areas related to a similar area in the contralateral hemisphere. Six months after treatment, perfusion maps did not show any interhemispheric difference. CONCLUSION Perfusion computed tomography could help to identify the hemodynamic disturbances associated with DAVFs with leptomeningeal venous drainage.

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