scholarly journals Bilateral Cervical Spinal Dural Arteriovenous Fistulas with Intracranial Venous Drainage Mimicking a Foramen Magnum Dural Arteriovenous Fistula

2013 ◽  
Vol 19 (4) ◽  
pp. 483-488 ◽  
Author(s):  
Steven W. Hetts ◽  
Joey D. English ◽  
Shirley I. Stiver ◽  
Vineeta Singh ◽  
Erin J. Yee ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Foramen Magnum ◽  
Venous Hypertension ◽  
Complex Case ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Diagnostic Angiography ◽  
Spinal Dural Arteriovenous Fistulas

We describe a unique case of bilateral cervical spinal dural arteriovenous fistulas mimicking an intracranial dural arteriovenous fistula near the foramen magnum. We review its detection via MRI and digital subtraction angiography and subsequent management through surgical intervention. Pitfalls in diagnostic angiography are discussed with reference to accurate location of the fistula site. The venous anastomotic connections of the posterior midline spinal vein to the medial posterior medullary vein, posterior fossa bridging veins, and dural venous sinuses of the skull base are discussed with reference to problem-solving in this complex case. The mechanism of myelopathy through venous hypertension produced by spinal dural fistulas is also emphasized.

scholarly journals Intracranial Dural Arteriovenous Fistula Presenting with Tetraparesis Due to Cervicomedullary Junction Compression

2004 ◽  
Vol 10 (4) ◽  
pp. 347-351 ◽  
Author(s):  
S.M. Chng ◽  
Y.Y. Sitoh ◽  
F. Hui
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Foramen Magnum ◽  
Venous Hypertension ◽  
Good Reduction ◽  
Arteriovenous Fistulas ◽  
Cervicomedullary Junction ◽  
Dural Arteriovenous Fistulas ◽  
Glue Embolization

Cranial dural arteriovenous fistulas (DAVFs) may give rise to myelopathy due to spinal perimedullary venous drainage causing intramedullary venous hypertension. Such cases are uncommon but not rare, with several cases reported in the literature. We report a case of foramen magnum DAVF presenting with symptoms of tetraparesis. The unusual feature was that in this case it was due to compression of the cervicomedullary junction by a large venous pouch rather than the result of spinal perimedullary venous hypertension. Transarterial glue embolization achieved good reduction of flow in the fistula with shrinkage of the venous pouch and corresponding clinical improvement.

scholarly journals Foramen magnum dural arteriovenous fistula presenting with epilepsy

2015 ◽  
Vol 21 (6) ◽  
pp. 724-727 ◽  
Author(s):  
Raoul Pop ◽  
Monica Manisor ◽  
Ziad Aloraini ◽  
Salvatore Chibarro ◽  
Francois Proust ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Clonic Seizure ◽  
Craniocervical Junction ◽  
Foramen Magnum ◽  
Venous Congestion ◽  
Arteriovenous Fistulas ◽  
Complex Anatomy ◽  
Significant Clinical Improvement

Intracranial dural arteriovenous fistulas (dAVFs) with perimedullary drainage represent a rare subtype of intracranial dAVF. Patients usually experience slowly progressive ascending myelopathy and/or lower brainstem signs. We present a case of foramen magnum dural arteriovenous fistula with an atypical clinical presentation. The patient initially presented with a generalised tonic-clonic seizure and no signs of myelopathy, followed one month later by rapidly progressive tetraplegia and respiratory insufficiency. The venous drainage of the fistula was directed both to the left temporal lobe and to the perimedullary veins (type III + V), causing venous congestion and oedema in these areas and explaining this unusual combination of symptoms. Rotational angiography and overlays with magnetic resonance imaging volumes were helpful in delineating the complex anatomy of the fistula. After endovascular embolisation, there was complete remission of venous congestion on imaging and significant clinical improvement. To our knowledge, this is the first report of a craniocervical junction fistula presenting with epilepsy.

Spinal dural arteriovenous fistula associated with a spinal perimedullary fistula

2006 ◽  
Vol 4 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Timo Krings ◽  
Volker A. Coenen ◽  
Martin Weinzierl ◽  
Marcus H. T. Reinges ◽  
Michael Mull ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Vascular Malformations ◽  
Venous Drainage ◽  
Elevated Pressure ◽  
Spinal Dural Arteriovenous Fistula ◽  
Arteriovenous Fistulas ◽  
Progressive Myelopathy ◽  
Dural Arteriovenous Fistulas

✓ Among spinal cord vascular malformations, dural arteriovenous fistulas (DAVFs) must be distinguished from intradural malformations. The concurrence of both is extremely rare. The authors report the case of a 35-year-old man who suffered from progressive myelopathy and who harbored both a DAVF and an intradural perimedullary fistula. During surgery, both fistulas were identified, confirmed, and subsequently obliterated. The fistulas were located at two levels directly adjacent to each other. Although the incidence of concurrent spinal DAVFs is presumed to be approximately 2%, the combination of a dural and an intradural fistula is exceedingly rare; only two other cases have been reported in the literature. One can speculate whether the alteration in venous drainage caused by the (presumably congenital) perimedullary fistula could possibly promote the production of a second dural fistula due to elevated pressure with concomitant venous stagnation and subsequent thrombosis. The authors conclude that despite the rarity of dual pathological entities, the clinician should be aware of the possibility of the concurrence of more than one spinal fistula in the same patient.

scholarly journals СLINICAL ASPECTS, DIAGNOSTICS AND MICROSURGICAL TREATMENT OF SPINAL DURAL ARTERIOVENOUS FISTULAS (LECTURE)

2019 ◽  
Vol 21 (2) ◽  
pp. 53-65
Author(s):  
G. Yu. Evzikov ◽  
V. А. Parfenov ◽  
А. V. Farafontov ◽  
P. V. Kuchuk ◽  
S. А. Kondrashin ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Spinal Dural Arteriovenous Fistula ◽  
Microsurgical Treatment ◽  
Arteriovenous Fistulas ◽  
Wide Range ◽  
Dural Arteriovenous Fistulas ◽  
Spinal Dural Arteriovenous Fistulas

The lecture is dedicated to spinal dural arteriovenous fistula – infrequent disorder which not well known among wide range of neurosurgeons. The findings on etiology, clinic and treatment are presented.

scholarly journals Dural arteriovenous fistula in the sphenoid bone lesser wing region: Endovascular adjuvant techniques of treatment and literature review

2018 ◽  
Vol 24 (5) ◽  
pp. 559-566 ◽  
Author(s):  
Dmitriy V Kandyba ◽  
Konstantin N Babichev ◽  
Artem V Stanishevskiy ◽  
Arevik A Abramyan ◽  
Dmytriy V Svistov
Keyword(s):  
Literature Review ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Sphenoid Bone ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
The Given ◽  
Balloon Protection

This article describes the successful endovascular treatment of a dural arteriovenous fistula of a rare localization (the area of sphenoid bone lesser region). We examine one report of an unusually located dural arteriovenous fistula successfully treated with Onyx (ev3, Irvine, USA) using a combination of endovascular adjuvant techniques: pressure cooker and remodeling balloon protection of cerebral artery. The article includes previously published observations of such fistulas and discusses anatomic features and venous drainage of dural arteriovenous fistulas in the given location.

Balloon-backstop technique: Preserving physiologic venous drainage during transvenous coil embolization of sigmoid sinus dural arteriovenous fistulas

2021 ◽  
pp. 197140092110428
Author(s):  
Madhavi Duvvuri ◽  
Michael T Caton ◽  
Kazim Narsinh ◽  
Matthew R Amans
Keyword(s):  
Arteriovenous Fistula ◽  
Coil Embolization ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Sigmoid Sinus ◽  
Transvenous Embolization ◽  
Venous Infarction ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Superior Petrosal Sinus

Dural arteriovenous fistulas can lead to catastrophic intracranial hemorrhage if left untreated. Transvenous embolization can cure arteriovenous fistulas, but preserving normal venous structures can be challenging. Inadvertent embolization of a functioning vein can result in catastrophic venous infarction or hemorrhage. Here, we report a case using balloon-assistance to facilitate preservation of the superior petrosal sinus during transvenous embolization of a sigmoid sinus dural arteriovenous fistula.

scholarly journals Dural Arteriovenous Fistula with Retrograde Drainage into the Cortical Veins (Case Report)

2021 ◽  
pp. 116-125
Author(s):  
A. S. Filatov ◽  
E. I. Kremneva ◽  
R. N. Konovalov ◽  
V. V. Sin’kova ◽  
A. A. Lyaskovik ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Cerebral Hemisphere ◽  
Dural Arteriovenous Fistula ◽  
Brain Mri ◽  
Venous Hypertension ◽  
Occipital Artery ◽  
Type Ii ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
First Time

We present clinical case of a patient who was referred for brain MRI to clarify the cause of a first-time seizure. MRI examination showed cortical and medullary veins ectasia in the left cerebral hemisphere with multiple cerebral microbleeds around the medullary veins. The revealed changes were considered as a manifestation of regional venous hypertension, however, its cause remained unclear. We decided to perform non-contrast 3D-TOF angiography that revealed a dural arteriovenous fistula between the left occipital artery and the sigmoid venous sinus with retrograde drainage into cortical veins (Borden type II, Cognard type IIb). Early diagnosis and treatment of «aggressive» dural arteriovenous fistulas avoids the development of lifethreatening complications (an annual hemorrhage rate of 8,1%).

Dural arteriovenous fistula presenting with dementia and bulbar symptoms

2020 ◽  
Vol 13 (7) ◽  
pp. e234907
Author(s):  
Christiana Avye Hall ◽  
David Swienton ◽  
Esteban Luis Taleti
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Hypertension ◽  
Neurological Deficits ◽  
Progressive Dementia ◽  
Arteriovenous Fistulas ◽  
Neurological Morbidity ◽  
Dural Arteriovenous Fistulas ◽  
Bulbar Symptoms ◽  
Tectal Plate

Dural arteriovenous fistulas are relatively rare. Some cases are difficult to diagnose, leading to unnecessary investigations, treatments and delays, particularly if the presentation is atypical. We report a case of a man who presented with progressive dementia and bulbar symptoms, both under-recognised non-haemorrhagic neurological deficits, caused by cortical venous hypertension. Brain imaging showed unusual bilateral thalamic, tectal plate and midbrain oedema. The patient was investigated and treated for alternative aetiologies, before being correctly diagnosed and managed using angiographic embolisation. His clinical and radiological signs improved significantly following treatment, reducing his risk of neurological morbidity and mortality.

Spinal dural arteriovenous fistula presenting with paraplegia following lumbar puncture

2013 ◽  
Vol 19 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Guus Koerts ◽  
Vincent Vanthuyne ◽  
Maxime Delavallee ◽  
Herbert Rooijakkers ◽  
Christian Raftopoulos
Keyword(s):  
Arteriovenous Fistula ◽  
Lumbar Puncture ◽  
Dural Arteriovenous Fistula ◽  
Treatment Options ◽  
Venous Hypertension ◽  
Spinal Dural Arteriovenous Fistula ◽  
Segmental Artery ◽  
Arteriovenous Fistulas ◽  
Underlying Mechanisms ◽  
Spinal Dural Arteriovenous Fistulas

Spinal dural arteriovenous fistulas are rare lesions with an annual incidence of 1 per 100,000 population. In patients with this disease, an abnormal vascular dural shunt exists between a dural branch of a segmental artery and a subdural radicular vein that drains the perimedullary venous system, leading to venous hypertension and secondary congestive myelopathy. Generally, patients present with progressive paraparesis, urinary disturbances, and gait ataxia. In this report the authors describe a 61-year-old woman with a spinal dural arteriovenous fistula who developed an acute paraplegia after a nontraumatic lumbar puncture. The possible underlying mechanisms and treatment options are discussed.

Advances in Surgical Approaches to Dural Fistulas

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S32-S41 ◽  
Author(s):  
Patrick P. Youssef ◽  
Albert Jess Schuette ◽  
C. Michael Cawley ◽  
Daniel L. Barrow
Keyword(s):  
Treatment Options ◽  
Venous Drainage ◽  
Venous Hypertension ◽  
Surgical Approaches ◽  
Dural Sinus ◽  
Intraoperative Angiography ◽  
Indocyanine Green Videoangiography ◽  
Arteriovenous Fistulas ◽  
The Past ◽  
Dural Arteriovenous Fistulas

Abstract Dural arteriovenous fistulas are abnormal connections of dural arteries to dural veins or venous sinuses originating from within the dural leaflets. They are usually located near or within the wall of a dural venous sinus that is frequently obstructed or stenosed. The dural fistula sac is contained within the dural leaflets, and drainage can be via a dural sinus or retrograde through cortical veins (leptomeningeal drainage). Dural arteriovenous fistulas can occur at any dural sinus but are found most frequently at the cavernous or transverse sinus. Leptomeningeal venous drainage can lead to venous hypertension and intracranial hemorrhage. The various treatment options include transarterial and transvenous embolization, stereotactic radiosurgery, and open surgery. Although many of the advances in dural arteriovenous fistula treatment have occurred in the endovascular arena, open microsurgical advances in the past decade have primarily been in the tools available to the surgeon. Improvements in microsurgical and skull base approaches have allowed surgeons to approach and obliterate fistulas with little or no retraction of the brain. Image-guided systems have also allowed better localization and more efficient approaches. A better understanding of the need to simply obliterate the venous drainage at the site of the fistula has eliminated the riskier resections of the past. Finally, the use of intraoperative angiography or indocyanine green videoangiography confirms the complete disconnection of fistula while the patient is still on the operating room table, preventing reoperation for residual fistulas.

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