Radiological and pathological aspects of dural arteriovenous fistulas

1986 ◽  
Vol 64 (6) ◽  
pp. 962-967 ◽  
Author(s):  
Douglas A. Graeb ◽  
Clarisse L. Dolman
Keyword(s):  
Superior Sagittal Sinus ◽  
Blood Clot ◽  
Pathological Examination ◽  
Pathological Findings ◽  
Content Type ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Av Fistulas

✓ A case of dural arteriovenous (AV) fistula is presented with detailed radiological and pathological findings. The complex hemodynamic alterations that may result from dural AV fistulas are described. Pathological examination in this case demonstrated widespread occlusion of the superior sagittal sinus with multiple abnormal fistulous communications between abnormal arteries and arterialized veins. A portion of the lesion resembled a recanalized blood clot, in support of the theory proposed by others that dural AV fistulas are acquired lesions.

Reversible acute and subacute myelopathy in patients with dural arteriovenous fistulas

1989 ◽  
Vol 70 (3) ◽  
pp. 354-359 ◽  
Author(s):  
Gregory R. Criscuolo ◽  
Edward H. Oldfield ◽  
John L. Doppman
Keyword(s):  
Surgical Techniques ◽  
Venous Congestion ◽  
Content Type ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Cord Injury ◽  
Dural Arteriovenous Fistulas ◽  
Av Malformation ◽  
Av Fistulas ◽  
Spinal Cord Dysfunction

✓ Acute or subacute neurological deterioration without evidence of hemorrhage in a patient with a spinal arteriovenous (AV) malformation has been referred to as “Foix-Alajouanine syndrome.” This clinical entity has been considered to be the result of progressive vascular thrombosis resulting in a necrotic myelopathy; it has therefore been thought to be largely irreversible and hence untreatable. The authors report five patients with dural AV fistulas who presented in this manner, and who improved substantially after embolic and surgical therapy. The outcome of these patients indicates that acute and subacute progression of myelopathy in cases of spinal dural AV fistulas may be caused by venous congestion and not necessarily by thrombosis. Therefore, a clinical diagnosis of Foix-Alajouanine syndrome is of little practical use, as spinal cord dysfunction from venous congestion is a potentially reversible process whereas thrombotic infarction is not. This diagnosis may result in suboptimal management. The recognition of nonhemorrhagic acute or subacute myelopathy as a complication of a spinal dural AV fistula is important since what appears to be irreversible cord injury is often treatable by standard surgical techniques.

scholarly journals Study of Dural Arteriovenous Fistula Drains into Leptomeningeal Vein without Sinus Interposition

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 127-134 ◽  
Author(s):  
T. Kawaguchi ◽  
M. Nakatani ◽  
T. Kawano
Keyword(s):  
Emergency Treatment ◽  
Superior Sagittal Sinus ◽  
Venous Drainage ◽  
Craniocervical Junction ◽  
Sigmoid Sinus ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Cranial Fossa ◽  
Venous Ischemia

We evaluated dural arteriovenous fistulas (DAVF) drains into leptomeningeal vein (LMV) without the venous sinus interposition. This type of DAVF contained the extra-sinusal type DAVF and the DAVF with so-called pure leptomeningeal venous drainage (PLMVD). We studied 15 patients with DAVF that flows into LMVD without passing into the sinus. The subjects were 5 patients with DAVF in the anterior cranial fossa, 2 with DAVF in the tentorium cerebelli, and 3 with DAVF in the craniocervical junction as extra-sinusal type DAVF and 3 with DAVF in the transverse sigmoid sinus and 2 with DAVF in the superior sagittal sinus as DAVF with PLMVD. This type appears to take a very aggressive course. The arterial pressure of the shunt is directly applied to LMV, which causes bending and winding of the vein, eventually varices, inducing intracranial haemorrhage or venous ischemia in the LMV reflux area. Emergency treatment should be performed as soon as possible. Although it is recognized that interruption of the draining vein is very effective, treatment methods such as TAE, direct surgery, and g knife treatment, or their combinations should be carefully chosen for each case.

scholarly journals Embolization of a superior sagittal sinus dural arteriovenous fistula under intrasinus balloon protection: A case report

2015 ◽  
Vol 21 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Yongxin Zhang ◽  
Qiang Li ◽  
Qing-hai Huang
Keyword(s):  
Dural Arteriovenous Fistula ◽  
Superior Sagittal Sinus ◽  
Therapeutic Option ◽  
Venous Drainage ◽  
Endovascular Embolization ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Cerebral Venous Drainage ◽  
Balloon Protection

Endovascular embolization has evolved to become the primary therapeutic option for dural arteriovenous fistulas (DAVFs). While guaranteeing complete occlusion of the fistula orifice, the goal of DAVF embolization is also to ensure the patency of normal cerebral venous drainage. This paper describes a case of successful embolization of a complex DAVF in the superior sagittal sinus with a multistaged approach using a combination of transvenous and transarterial tactics. The strategies and techniques are discussed.

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.

Fatal progression of posttraumatic dural arteriovenous fistulas refractory to multimodal therapy

2001 ◽  
Vol 94 (5) ◽  
pp. 831-835 ◽  
Author(s):  
Jonathan A. Friedman ◽  
Fredric B. Meyer ◽  
Douglas A. Nichols ◽  
Robert J. Coffey ◽  
L. Nelson Hopkins ◽  
...  
Keyword(s):  
Multimodal Therapy ◽  
Transarterial Embolization ◽  
Subsequent Treatment ◽  
Venous Hypertension ◽  
Content Type ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Pulsatile Mass ◽  
Dural Arteriovenous Fistulas ◽  
Fine Print

✓ The authors report the case of a man who suffered from progressive, disseminated posttraumatic dural arteriovenous fistulas (DAVFs) resulting in death, despite aggressive endovascular, surgical, and radiosurgical treatment. This 31-year-old man was struck on the head while playing basketball. Two weeks later a soft, pulsatile mass developed at his vertex, and the man began to experience pulsatile tinnitus and progressive headaches. Magnetic resonance imaging and subsequent angiography revealed multiple AVFs in the scalp, calvaria, and dura, with drainage into the superior sagittal sinus. The patient was treated initially with transarterial embolization in five stages, followed by vertex craniotomy and surgical resection of the AVFs. However, multiple additional DAVFs developed over the bilateral convexities, the falx, and the tentorium. Subsequent treatment entailed 15 stages of transarterial embolization; seven stages of transvenous embolization, including complete occlusion of the sagittal sinus and partial occlusion of the straight sinus; three stages of stereotactic radiosurgery; and a second craniotomy with aggressive disconnection of the DAVFs. Unfortunately, the fistulas continued to progress, resulting in diffuse venous hypertension, multiple intracerebral hemorrhages in both hemispheres, and, ultimately, death nearly 5 years after the initial trauma. Endovascular, surgical, and radiosurgical treatments are successful in curing most patients with DAVFs. The failure of multimodal therapy and the fulminant progression and disseminated nature of this patient's disease are unique.

The Strategy of Dural Arteriovenous Fistula with Isolated Sinus

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 113-116 ◽  
Author(s):  
O. Masuo ◽  
T. Terada ◽  
M. Tsuura ◽  
Y. Kinoshita ◽  
H. Yokote ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Dural Arteriovenous Fistula ◽  
Superior Sagittal Sinus ◽  
Transarterial Embolization ◽  
Sigmoid Sinus ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Initial Symptoms ◽  
Dural Arteriovenous Fistulas ◽  
Ischemic Attack

We treated 7 cases of dural arteriovenous fistulas (dAVF) with isolated sinus by transvenous direct embolization. The fistulas located in the transverse-sigmoid sinus in 5 cases, superior sagittal sinus in 1 case and transverse-sigmoid and superior sagittal sinus in 1 case. The initial symptoms were generalized convulsion in 2 cases, disturbed consciousness in 1 case, tinnitus in 2 cases and transient ischemic attack in 2 cases. We performed sinus packing with coils in all cases following transarterial embolization. All patients improved neurologically after the treatments and AVFs completely disappeared in all cases.

scholarly journals Ethmoidal dural Arteriovenous Fistula- A case report

2020 ◽  
Vol 1 (1) ◽  
pp. 33-35
Author(s):  
Pankaj Raj Nepal ◽  
Karuna Tamrakar Karki ◽  
Dinesh Kumar Thapa
Keyword(s):  
Case Report ◽  
Frontal Lobe ◽  
Similar Case ◽  
Superior Sagittal Sinus ◽  
Rare Type ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Ethmoidal Artery ◽  
Cranial Fossa

Ethmoidal dural arteriovenous fistulas (dAVF) are a rare type of dAVF present in the anterior cranial fossa. There are usually fed by the ethmoidal artery and drains into superior sagittal sinus. Due to its high flow nature, they are considered a challenging case for surgery and usually present with frontal lobe hematoma or seizure. Here, is a similar case report of a 52-year-old gentleman who presented with sequel of frontal lobe hematoma and was managed surgically with clipping of feeder and excision of fistula.

Sagittal sinus thrombosis related to oral contraceptives

1970 ◽  
Vol 33 (6) ◽  
pp. 714-717 ◽  
Author(s):  
Michael C. Shende ◽  
Herbert Lourie
Keyword(s):  
Oral Contraceptives ◽  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Obstructive Hydrocephalus ◽  
Pathological Findings ◽  
Content Type ◽  
Sagittal Sinus ◽  
Contraceptive Pills ◽  
Sagittal Sinus Thrombosis ◽  
Fine Print

✓ A case of thrombosis of the cortical veins and superior sagittal sinus occurred in a young woman with no obvious predisposing factors other than the possible implication of contraceptive pills. Angiographic, surgical, and pathological findings are presented. Survival in this case resulted from a large cranial decompression, and later a ventriculojugular shunt to control extraventricular obstructive hydrocephalus.

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