A sacral dural arteriovenous fistula presenting with an intermittent myelopathy aggravated by menstruation

✓ The case is reported of a woman with a spinal dural arteriovenous fistula whose intermittent myelopathy became aggravated with menstruation. Her symptoms recurred in spite of successful acrylic embolization of the lateral sacral arteriovenous fistula. Repeat angiography showed venous drainage from the uterus toward the medullary vein. Total abdominal hysterectomy cured her symptoms. The pathophysiological basis for this peculiar clinical manifestation and its management are discussed.

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Spinal epidural arteriovenous fistula with intramedullary reflux

Journal of Neurosurgery ◽

10.3171/jns.1997.87.4.0633 ◽

1997 ◽

Vol 87 (4) ◽

pp. 633-635 ◽

Cited By ~ 45

Author(s):

Farhad Pirouzmand ◽

M. Christopher Wallace ◽

Robert Willinsky

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Rare Entity ◽

Spinal Dural Arteriovenous Fistula ◽

Content Type ◽

Spinal Epidural ◽

Fine Print

✓ A spinal epidural arteriovenous fistula with secondary reflux into the perimedullary veins is a rare entity. The authors present such a case with a discussion of its pathophysiology and treatment. The mechanism for formation of a spinal dural arteriovenous fistula is outlined based on the anatomical substrates in this region.

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The clinical value of venous drainage in patients with spinal dural arteriovenous fistula

Journal of the Neurological Sciences ◽

10.1016/j.jns.2018.12.024 ◽

2019 ◽

Vol 397 ◽

pp. 50-54 ◽

Cited By ~ 2

Author(s):

F. Jablawi ◽

M. Mull

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Venous Drainage ◽

Clinical Value ◽

Spinal Dural Arteriovenous Fistula

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

Journal of Neurosurgery ◽

10.3171/jns.2002.97.2.0467 ◽

2002 ◽

Vol 97 (2) ◽

pp. 467-470 ◽

Cited By ~ 7

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.

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Dural arteriovenous fistula of the posterior fossa developing after surgical occlusion of the sigmoid sinus

Journal of Neurosurgery ◽

10.3171/jns.1996.84.1.0113 ◽

1996 ◽

Vol 84 (1) ◽

pp. 113-118 ◽

Cited By ~ 56

Author(s):

Toshisuke Sakaki ◽

Tetsuya Morimoto ◽

Hiroyuki Nakase ◽

Toshio Kakizaki ◽

Kiyoshi Nagata

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Sinus Thrombosis ◽

Sigmoid Sinus ◽

Tumor Surgery ◽

Content Type ◽

Sinus Wall ◽

Before And After ◽

Tumor Involvement ◽

Fine Print

✓ In this article, the authors present five cases of dural arteriovenous fistula (AVF) that developed in the transverse—sigmoid sinus 2 to 6 years after sacrifice of the sigmoid sinus because of tumor involvement. The original tumor was meningioma in two patients and neurinoma, glomus jugulare tumor, and ameloblastoma in one patient each. The involved sigmoid sinus was resected along with the tumor and ligated at the normal edge; all that remained of the sigmoid sinus was a small stump on the retrosigmoid portion. Serial angiography performed before and after tumor surgery revealed no abnormal arteriovenous communications or dural AVF in any of the cases. Although many reports have suggested that sinus thrombosis is a precipitating factor in the pathogenesis of dural AVFs, this has been difficult to verify because of the small number of cases in which serial angiography was performed before the development of a dural AVF. In all of the cases presented in this article, surgical resection of a dural AVF and histological examination were performed. Subintimal fibrous thickening was marked, and the sinus wall was found to contain many dural vessels. Organized thrombosis with neovascularization was seen in only two patients. These cases demonstrate that subintimal fibrous thickening and a hypertrophied sinus wall secondary to increased intrasinus pressure or sinus thrombosis occurring after sinus occlusion can provoke the development of a dural AVF within the course of a lifetime. Maintenance of intrasinus blood flow may be very important to prevent this late postoperative complication.

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Stereotactic radiosurgery for dural arteriovenous fistula involving the superior sagittal sinus

Journal of Neurosurgery ◽

10.3171/jns.2002.97.supplement_5.0481 ◽

2002 ◽

Vol 97 ◽

pp. 481-483 ◽

Cited By ~ 13

Author(s):

Keisuke Maruyama ◽

Masahiro Shin ◽

Hiroki Kurita ◽

Masao Tago ◽

Takaaki Kirino

Keyword(s):

Arteriovenous Fistula ◽

Stereotactic Radiosurgery ◽

Gamma Knife ◽

Dural Arteriovenous Fistula ◽

Superior Sagittal Sinus ◽

Gamma Knife Radiosurgery ◽

Content Type ◽

Sagittal Sinus ◽

Fine Print

✓The authors present a case of ruptured dural arteriovenous fistula primarily draining into the superior sagittal sinus, which was successfully treated by gamma knife radiosurgery.

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Spinal dural arteriovenous fistula associated with a spinal perimedullary fistula

Journal of Neurosurgery Spine ◽

10.3171/spi.2006.4.3.241 ◽

2006 ◽

Vol 4 (3) ◽

pp. 241-245 ◽

Cited By ~ 20

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.

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A cervical dural arteriovenous fistula in a patient presenting with radiculopathy

Journal of Neurosurgery ◽

10.3171/jns.1996.84.1.0119 ◽

1996 ◽

Vol 84 (1) ◽

pp. 119-123 ◽

Cited By ~ 37

Author(s):

Michihiro Kohno ◽

Hiroshi Takahashi ◽

Katsuhisa Ide ◽

Buichi Ishijima ◽

Katsuhiro Yamada ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Ct Scanning ◽

Mass Effect ◽

Preoperative Embolization ◽

Venous Plexus ◽

Content Type ◽

Embolization Therapy ◽

Dynamic Ct Scanning ◽

Fine Print

✓ A 51-year-old man presenting with radiculopathy with a rare cervical dural arteriovenous fistula (AVF) is reported. Angiography revealed that the cervical dural AVF was fed mainly by the left C-3 and C-4 radicular arteries and drained into the internal vertebral venous plexus with no communication with intradural structures. The dural AVF was treated surgically after embolization therapy. Although the AVF showed mass effect on computerized tomography (CT) scanning, abnormal vessels, which were suspected to drain the AVF, were observed intraoperatively to compress the left C-4 and C-5 nerve root sleeves. After resection of these abnormal epidural vessels, monoparesis of the left proximal upper extremity was markedly improved. In this patient, dynamic CT scanning was useful in the initial diagnosis, and the preoperative embolization therapy was very effective.

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Positional vomiting due to a thoracic spinal dural arteriovenous fistula

Journal of Neurosurgery Spine ◽

10.3171/spi.2004.1.2.0219 ◽

2004 ◽

Vol 1 (2) ◽

pp. 219-222 ◽

Cited By ~ 5

Author(s):

Dennis J. Cordato ◽

Mark A. Davies ◽

Lynette T. Masters ◽

Phillip D. Cremer ◽

Raymond S. Schwartz ◽

...

Keyword(s):

Mr Imaging ◽

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Venous Hypertension ◽

High Signal ◽

Spinal Dural Arteriovenous Fistula ◽

Content Type ◽

Signal Abnormality ◽

Thoracic Spinal ◽

The Brain

✓ The authors report the unique case of a patient with a thoracic spinal dural arteriovenous fistula (DAVF) causing remote brainstem symptoms of positional vomiting and minimal vertigo. Magnetic resonance (MR) imaging of the brain demonstrated high signal abnormality in the medulla, presumably related to venous hypertension, and spinal MR imaging revealed markedly dilated veins along the dorsal aspect of the cord. Spinal angiography confirmed the presence of a thoracic spinal DAVF. Disconnection of the DAVF from the spine resulted in a marked improvement in symptoms and resolution of the preoperative MR imaging—documented abnormalities. The authors highlight the rare syndrome of positional vomiting as a brainstem symptom and conclude that spinal DAVFs should be considered in the differential diagnosis of high signal MR imaging abnormalities localized to the brainstem.

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Transumbilical embolization of a congenital dural arteriovenous fistula at the torcular herophili in a neonate

Journal of Neurosurgery ◽

10.3171/jns.1999.90.5.0964 ◽

1999 ◽

Vol 90 (5) ◽

pp. 964-969 ◽

Cited By ~ 17

Author(s):

Masaki Komiyama ◽

Misao Nishikawa ◽

Shouhei Kitano ◽

Hiroaki Sakamoto ◽

Nobuhiro Miyagi ◽

...

Keyword(s):

Heart Failure ◽

Arteriovenous Fistula ◽

Blood Supply ◽

Dural Arteriovenous Fistula ◽

Vascular Anomaly ◽

Venous Intervention ◽

Transvenous Embolization ◽

Content Type ◽

Fine Print ◽

High Output

✓ A neonate, in whom a congenital cerebral vascular anomaly had been diagnosed prenatally, exhibited progressive high-output congestive heart failure soon after birth. Cerebral angiography revealed a congenital dural arteriovenous fistula (AVF) with a huge dural lake located at the torcular herophili. In addition to the meningeal blood supply, an unusual pial blood supply from all cerebellar arteries was observed to feed the fistula. The patient was treated by repeated transarterial and transvenous embolization through the umbilical venous route. To the authors' knowledge, neither the existence of a congenital dural AVF at the torcular herophili presenting with an enormous pial blood supply or the technique of transumbilical venous intervention has been reported in the literature.

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