A case of dural arteriovenous fistula draining to the diploic vein presenting with intracerebral hemorrhage

2016 ◽  
Vol 124 (3) ◽  
pp. 726-729 ◽  
Author(s):  
Rie Yako ◽  
Osamu Masuo ◽  
Kenji Kubo ◽  
Yasuhiko Nishimura ◽  
Naoyuki Nakao
Keyword(s):  
Intracerebral Hemorrhage ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Unusual Case ◽  
Transarterial Embolization ◽  
Ct Scanning ◽  
Middle Meningeal Artery ◽  
Disturbance Of Consciousness ◽  
Cortical Venous Reflux ◽  
The Right

The authors report an unusual case of a dural arteriovenous fistula (dAVF) draining only to the diploic vein and causing intracerebral hemorrhage. A 62-year-old woman presented with disturbance of consciousness and left hemiparesis. Brain CT scanning on admission showed a right frontal subcortical hemorrhage. Digital subtraction angiography revealed an arteriovenous shunt located in the region around the pterion, which connected the frontal branch of the right middle meningeal artery with the anterior temporal diploic vein and drained into cortical veins in a retrograde manner through the falcine vein. The dAVF was successfully obliterated by percutaneous transarterial embolization with N-butyl-2-cyanoacrylate. The mechanism of retrograde cortical venous reflux causing intracerebral hemorrhage is discussed.

scholarly journals A Case of Spontaneous Acute Subdural Hemorrhage Caused by a Dural Arteriovenous Fistula on the Convexity without Cortical Venous Reflux

2019 ◽  
Vol 11 (3) ◽  
pp. 312-318 ◽  
Author(s):  
Keita Yamauchi ◽  
Shunsuke Takenaka ◽  
Tomohiro Iida ◽  
Hideki Sakai
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Middle Meningeal Artery ◽  
Neurological Deficits ◽  
Acute Subdural Hematoma ◽  
Subdural Hemorrhage ◽  
Venous Reflux ◽  
Sagittal Sinus ◽  
Cortical Venous Reflux

Bleeding from a dural arteriovenous fistula (DAVF) typically occurs in the form of an intracerebral or subarachnoid hemorrhage. Here, we report a rare case of a DAVF with an acute subdural hematoma (ASDH). A 29-year-old male presented to the emergency department with a complaint of progressing headache and nausea, with no reported episode of head trauma. Non-contrast CT revealed a left ASDH with a moderate midline shift. Digital subtraction angiography revealed a DAVF on the left parietal convexity. The DAVF was fed by the middle meningeal artery and drained into the superior sagittal sinus and the sphenoparietal sinus via the diploic vein without cortical venous reflux. The DAVF was treated with transarterial embolization using 25% diluted n-butyl cyanoacrylate prior to hematoma removal. The bleeding point was confirmed on the inner surface of the dura mater. The patient recovered well without any neurological deficits.

Transarterial embolization with ONYX for treatment of intracranial non-cavernous dural arteriovenous fistula with or without cortical venous reflux

2011 ◽  
Vol 3 (3) ◽  
pp. 224-228 ◽  
Author(s):  
K. De Keukeleire ◽  
P. Vanlangenhove ◽  
J.-P. Kalala Okito ◽  
G. Hallaert ◽  
D. Van Roost ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Venous Reflux ◽  
Cortical Venous Reflux

scholarly journals Left temporal craniotomy and direct microcatheterization of the middle meningeal artery for treatment of a complex temporal dural arteriovenous fistula

2019 ◽  
Vol 46 (Suppl_2) ◽  
pp. V8
Author(s):  
Daniel M. S. Raper ◽  
Nasser Mohammed ◽  
M. Yashar S. Kalani ◽  
Min S. Park
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Treatment Approach ◽  
Transarterial Embolization ◽  
Middle Meningeal Artery ◽  
Intraoperative Angiography ◽  
Arteriovenous Fistulae ◽  
Posterior Division ◽  
Technical Considerations ◽  
Meningeal Artery

The preferred method for treating complex dural arteriovenous fistulae of the transverse and sigmoid sinuses is via endovascular, transarterial embolization using liquid embolysate. However, this treatment approach mandates access to distal dural feeding arteries that can be technically challenging by standard endovascular approaches. This video describes a left temporal craniotomy for direct stick microcatheterization of an endovascularly inaccessible distal posterior division of the middle meningeal artery for embolization of a complex left temporal dural arteriovenous fistula. The case was performed in the hybrid operative suite with biplane intraoperative angiography. Technical considerations, operative nuances, and outcomes are reviewed.The video can be found here: https://youtu.be/Dnd4yHgaKcQ.

True Aneurysm on the Posterior Meningeal Artery Associated With a Dural Arteriovenous Fistula

Neurosurgery ◽  
2010 ◽  
Vol 67 (3) ◽  
pp. E876-E877 ◽  
Author(s):  
Kenji Muro ◽  
Joseph G. Adel ◽  
Numa R. Gottardi-Littell ◽  
Christopher C. Getch ◽  
H. Hunt Batjer
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Unusual Case ◽  
Vascular Malformations ◽  
Management Plan ◽  
En Bloc ◽  
True Aneurysm ◽  
The Right ◽  
Posterior Meningeal Artery ◽  
Meningeal Artery

Abstract BACKGROUND We report an unusual case of a true dural aneurysm arising from the posterior meningeal artery that fed a symptomatic dural arteriovenous fistula located at the right transverse-sigmoid sinus junction. CLINICAL PRESENTATION A 29-year-old right-handed white woman presented with aneurysmal dilatation of hypertrophied posterior meningeal artery feeding a partially treated dural arteriovenous fistula. INTERVENTION The aneurysm, which measured approximately 3 mm in width and 5 mm in length, was located in the intracranial space with a thin-walled dome projecting toward the cerebellum. Its afferent and efferent vessels were identified, secured, and the lesion was excised en bloc. CONCLUSION A thorough evaluation of all diagnostic studies should be performed for patients with vascular malformations to help identify these or other unusual lesions that may aid in the risk stratification process and management plan.

scholarly journals Transarterial Embolization of a Cervical Dural Arteriovenous Fistula

2006 ◽  
Vol 12 (4) ◽  
pp. 313-318 ◽  
Author(s):  
S.A. Ansari ◽  
J.P. Lassig ◽  
E. Nicol ◽  
B.G. Thompson ◽  
J.J. Gemmete ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Venous Drainage ◽  
Acute Onset ◽  
Drainage Patterns ◽  
The Right ◽  
Glue Embolization

We describe a case of a 75-year-old man who presented with acute onset of headache and subarachnoid hemorrhage and initial cerebral angiography was deemed “negative”. In retrospect, a faint contrast collection was present adjacent to the right vertebral artery at the C1 level suspicious for a small dural arteriovenous fistula (dAVF). Follow-up angiography with selective micro-catheter injections of the right vertebral artery and C1 radicular artery confirmed a complex dAVF with characteristically specific venous drainage patterns associated with a subarachnoid hemorrhage presentation. Subsequently, the cervical dAVF was treated with superselective glue embolization resulting in complete occlusion. Cervical dAVFs are extremely rare vascular causes of subarachnoid hemorrhage. Both diagnostic angiography and endovascular treatment of these lesions can be challenging, especially in an emergent setting, requiring selective evaluation of bilateral vertebral arteries and careful attention to their cervical segments. Although only a single prior case of a cervical dAVF presenting with subarachnoid hemorrhage has been successfully treated with embolization, modern selective transarterial techniques may allow easier detection and treatment of subtle pathologic arteriovenous connections.

scholarly journals A hemorrhagic complication after Onyx embolization of a tentorial dural arteriovenous fistula: A caution about subdural extension with pial arterial supply

2017 ◽  
Vol 23 (3) ◽  
pp. 307-312 ◽  
Author(s):  
Kenichi Sato ◽  
Yasushi Matsumoto ◽  
Hidenori Endo ◽  
Teiji Tominaga
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Proximal Part ◽  
Middle Meningeal Artery ◽  
Arterial Supply ◽  
Acute Subdural Hematoma ◽  
Hemorrhagic Complication ◽  
Subdural Space ◽  
Arterial Bleeding

We report a case of tentorial dural arteriovenous fistula (DAVF) with a severe intracranial hemorrhage occurring after Onyx embolization. A 40-year-old man presented with an asymptomatic tentorial DAVF on angiography. Transarterial embolization with Onyx was performed via the middle meningeal artery, and the cast filled the fistula itself and its proximal draining vein. Postoperative angiography confirmed complete occlusion of the DAVF. A computed tomography scan performed immediately after the procedure demonstrated an acute subdural hematoma with the temporal hemorrhage. Emergency craniotomy revealed continuous arterial bleeding from a viable glomus-like vascular structure around the proximal part of the embolized draining vein, fed by a pial artery arising from the posterior cerebral artery. Pathologic findings suggested diagnosis of vascular malformation extending into the subdural space. Tentorial DAVFs can extend to the subdural space along their drainage route, and may be involved in severe hemorrhagic complications of curative endovascular treatment using Onyx, particularly those with pial arterial supply.

scholarly journals Transarterial Embolization of a Transverse Sinus Dural Arteriovenous Fistula: 2-Dimensional Operative Video

2020 ◽  
Vol 20 (1) ◽  
pp. E41-E42
Author(s):  
Santiago Gomez-Paz ◽  
Yosuke Akamatsu ◽  
Mohamed M Salem ◽  
Justin M Moore ◽  
Christopher S Ogilvy ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Vision Loss ◽  
Transarterial Embolization ◽  
Sudden Onset ◽  
Strenuous Exercise ◽  
Initial Assessment ◽  
Significant Past Medical History ◽  
Patient Consent ◽  
The Right

Abstract A 40-yr-old male with no significant past medical history presented with sudden onset right-sided retro-orbital headache associated with vision loss after a session of strenuous exercise. Initial assessment with noncontrast head computed tomography at the local emergency department revealed a right sided occipital intracranial hemorrhage (ICH). On arrival the patient ad a left quadrantopsia with Glasgow Coma Scale of 15 and an ICH score of 0. A computed tomographic angiography showed a high density 6 × 9 mm vascular lesion associated with 2 tortuous vessels. Cerebral angiography revealed a right sided dural arteriovenous fistula, Cognard Type IV, with arterial feeders arising from dural branches of the right vertebral artery, the posterior division of the right middle meningeal artery and meningeal branches distal to the neuromeningeal trunk of the left ascending pharyngeal artery.1 Four days after the ICH event the patient was treated with endovascular Onyx embolization of the fistula, through a transradial approach. Immediate angiographic assessment showed complete obliteration of the dAVF. The patient was discharged home and recovered his visual field deficit over 3 mo. The following operative video includes a discussion of the endovascular technique and treatment nuances associated with the transarterial management of a dural arteriovenous fistula. Patient consent was given prior to the procedure and consent and approval for this operative video was waived due to the retrospective nature of this manuscript and the anonymized video material.

scholarly journals Onyx Distal Embolization in Transarterial Embolization of Dural Arteriovenous Fistula with Subtotally Isolated Transverse-Sigmoid Sinus

2009 ◽  
Vol 15 (2) ◽  
pp. 223-228 ◽  
Author(s):  
Y. Jiang ◽  
Y. Li ◽  
Z. Wu
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Sigmoid Sinus ◽  
Heart Ventricle ◽  
Distal Embolization ◽  
Right Heart ◽  
Combination Approach ◽  
The Right

We describe a 39-year-old woman with dural arteriovenous fistula in the region of transverse-sigmoid sinus. A combination approach was designed to treat the fistula but the balloon failed to pass the severely stenosed proximal end of a subtotally isolated sinus. Although successfully occlusion of most feeding arteries from a single arterial injection was achieved, Onyx was found to shift to the outflow tract of the right heart ventricle and then to the lung latterly on six month follow-up.

Republished: Isolated intraventricular hemorrhage secondary to dural arteriovenous fistula

2018 ◽  
Vol 10 (5) ◽  
pp. e7-e7 ◽  
Author(s):  
Krishna Amuluru ◽  
Fawaz Al-Mufti ◽  
Charles Romero
Keyword(s):  
Arteriovenous Fistula ◽  
Intraventricular Hemorrhage ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Multimodality Treatment ◽  
Radiographic Evidence ◽  
Venous Flow ◽  
First Case ◽  
Cortical Venous Reflux ◽  
Underlying Pathophysiology

Isolated intraventricular hemorrhage due to dural arteriovenous fistula (dAVF) is extremely rare and has been reported only a few times in the literature. The pathophysiological cause of isolated intraventricular hemorrhage in these cases was hypothetically attributed to retrograde venous flow into subependymal vessels, although none of these cases demonstrated radiographic evidence of such reflux. We present the first case of a dAVF with radiographic evidence of severe cortical venous reflux into the subependymal venous network causing isolated intraventricular hemorrhage, thus lending proof for the underlying pathophysiology. Furthermore, ours is the first case of dAVF with isolated intraventricular hemorrhage that was successfully treated using multimodality transvenous and transarterial embolization techniques. In cases of high-grade dAVF, multimodality treatment may offer the greatest chance for success, and should be strongly considered for management.

scholarly journals Non-sinus-type Dural Arteriovenous Fistula Cured by Transarterial Embolization from Middle Meningeal Artery: Two Case Reports

2018 ◽  
Vol 12 (11) ◽  
pp. 542-545
Author(s):  
Kenyu Hayashi ◽  
Yuki Ohmori ◽  
Yasuyuki Kaku ◽  
Yushin Takemoto ◽  
Takashi Nakagawa ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Case Reports ◽  
Transarterial Embolization ◽  
Middle Meningeal Artery ◽  
Meningeal Artery
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