Dural arteriovenous malformation of the skull base with intraosseous vascular nidus

1994 ◽  
Vol 81 (4) ◽  
pp. 620-623 ◽  
Author(s):  
Ghaus M. Malik ◽  
Asim Mahmood ◽  
Bharat A. Mehta

✓ Intracranial arteriovenous malformations (AVM's) have been classified as pure pial, pure dural, and mixed pial and dural. Dural AVM's are relatively uncommon, with 377 cases documented up to 1990. These lesions were believed to be situated within the walls of the sinuses, but during the last decade researchers discovered a small subgroup of dural AVM's in extrasinusal locations such as the skull base and tentorium. Two of the 17 patients who were studied between 1976 and 1993 had dural AVM's that were entirely intraosseous except for their venous drainage, which was via the dural venous sinuses. Although such intraosseous dural AVM's have not been previously described, the authors elected to group these malformations with dural AVM's because their venous drainage was intracranial and angiograms revealed identical features.

1975 ◽  
Vol 43 (1) ◽  
pp. 104-107 ◽  
Author(s):  
Cecil J. Hash ◽  
Charles B. Grossman ◽  
Henry A. Shenkin

✓ The authors report the case of a patient with subarachnoid hemorrhage in whom an intracranial dural arteriovenous malformation coexisted with a spinal arteriovenous malformation. The latter was considered to be the source of the hemorrhage by clinical and radiographic criteria. It is concluded that patients with subarachnoid hemorrhage who show no suitable intracranial source for their bleed in some instances should be investigated for a spinal origin of hemorrhage.


1996 ◽  
Vol 85 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Sean Mullan ◽  
Saeid Mojtahedi ◽  
Douglas L. Johnson ◽  
R. Loch MacDonald

✓ Three cases of cerebral venous malformation (CVM) are presented to demonstrate the triad that characterizes CVM: abnormal surface venous drainage, a “star-cluster” system of deep collecting veins, and a deep draining vein. Four other cases are introduced that illustrate this triad and show an additional feature, namely arterial fistulization; these cases represent arteriovenous malformations (AVMs). A final case demonstrates a CVM within an AVM. Both of these structures have a common draining vein and an identical venous core. On the basis of the cases described and of others less suitable for illustration, it is postulated that an AVM is a fistulized CVM and that both relate to a failure in the development of the cortical venous mantle. This proposition is based on the authors' observations and their assessment of the “best possible fit.”


1977 ◽  
Vol 47 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Hiroshi Matsumura ◽  
Yasumasa Makita ◽  
Kuniyuki Someda ◽  
Akinori Kondo

✓ We have operated on 12 of 14 cases of arteriovenous malformation (AVM) in the posterior fossa since 1968, with one death. The lesions were in the cerebellum in 10 cases (three anteromedial, one central, three lateral, and three posteromedial), and in the cerebellopontine angle in two; in two cases the lesions were directly related to the brain stem. The AVM's in the anterior part of the cerebellum were operated on through a transtentorial occipital approach.


1979 ◽  
Vol 51 (5) ◽  
pp. 715-717 ◽  
Author(s):  
Shunro Endo ◽  
Keiji Koshu ◽  
Jiro Suzuki

✓ The authors report a case of infratentorial arteriovenous malformation that regressed spontaneously within 25 months without bleeding episodes or surgical intervention. The patient's clinical symptoms, left-sided tinnitus, cranial bruit, and right homonymous hemianopsia, disappeared completely over the same period.


2001 ◽  
Vol 95 (2) ◽  
pp. 346-349 ◽  
Author(s):  
Francisco A. Ponce ◽  
Patrick P. Han ◽  
Robert F. Spetzler ◽  
Alexa Canady ◽  
Iman Feiz-Erfan

✓ Wyburn-Mason syndrome is a rare condition associated with multiple cerebral arteriovenous malformations. The disease, also called retinoencephalofacial angiomatosis, includes lesions of the retina, brain, and skin. This disorder stems from a vascular dysgenesis of the embryological anterior plexus early in the gestational period when the primitive vascular mesoderm is shared by the involved structures. The timing of the insult to the embryonic tissue determines which structures are affected. Extensions of the lesions vary widely but cutaneous lesions are unusual. Among reports in the literature, only three cases appear to have manifested without retinal involvement. The authors report the fourth case of Wyburn-Mason syndrome in which there was no retinal involvement and the first to involve neither the retina nor the face.


1999 ◽  
Vol 91 (2) ◽  
pp. 303-307 ◽  
Author(s):  
John Ratliff ◽  
Rand M. Voorhies

✓ This 24-year-old man presented with an unusual case of a high-flow arteriovenous fistula (AVF). This lesion was similar to giant AVFs in children that have been previously described in the literature. In patients in whom abnormalities of the vein of Galen have been excluded and in whom presentation occurs after 20 years of age, a diagnosis of congenital AVF is quite unusual.The fistula in this case originated in an enlarged callosomarginal artery and drained into the superior sagittal sinus via a saccular vascular abnormality. Two giant aneurysmal dilations of the fistula were present. In an associated finding, a small falcine dural arteriovenous malformation (AVM) was also present. Arterial supply to the AVM arose from both external carotid arteries and the left vertebral artery, with drainage through an aberrant vein in the region of the inferior sagittal sinus into the vein of Galen.Craniotomy with exposure and trapping of the AVF was performed, with subsequent radiosurgical (linear accelerator) treatment of the dural AVM. Through this combination of microsurgical trapping of the AVF and radiotherapy of the dural AVM, an excellent clinical outcome was achieved.


2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 104-106 ◽  
Author(s):  
Yang Kwon ◽  
Sang Ryong Jeon ◽  
Jeong Hoon Kim ◽  
Jung Kyo Lee ◽  
Dong Sook Ra ◽  
...  

Object. The authors sought to analyze causes for treatment failure following gamma knife radiosurgery (GKS) for intracranial arteriovenous malformations (AVMs), in cases in which the nidus could still be observed on angiography 3 years postsurgery. Methods. Four hundred fifteen patients with AVMs were treated with GKS between April 1990 and March 2000. The mean margin dose was 23.6 Gy (range 10–25 Gy), and the mean nidus volume was 5.3 cm3 (range 0.4–41.7 cm3). The KULA treatment planning system and conventional subtraction angiography were used in treatment planning. One hundred twenty-three of these 415 patients underwent follow-up angiography after GKS. After 3 years the nidus was totally obliterated in 98 patients (80%) and partial obliteration was noted in the remaining 25. There were several reasons why complete obliteration was not achieved in all cases: inadequate nidus definition in four patients, changes in the size and location of the nidus in five patients due to recanalization after embolization or reexpansion after hematoma reabsorption, a large AVM volume in five patients, a suboptimal radiation dose to the thalamic and basal ganglia in eight patients, and radioresistance in three patients with an intranidal fistula. Conclusions. The causes of failed GKS for treatment of AVMs seen on 3-year follow-up angiograms include inadequate nidus definition, large nidus volume, suboptimal radiation dose, recanalization/reexpansion, and radioresistance associated with an intranidal fistula.


1973 ◽  
Vol 39 (5) ◽  
pp. 652-655 ◽  
Author(s):  
Anthony D. Oliver ◽  
Charles B. Wilson ◽  
Edwin B. Boldrey

✓ Two cases of spinal arteriovenous malformation (AVM) are reported because of a previously unobserved clinical feature: recurrent transient postprandial paresis of the legs. The authors believe the paresis was caused by chronic shunting of blood away from the cord and into the low-resistance AVM. Symptomatic cord ischemia might then be precipitated by vasodilatation in other areas of the body such as the splanchnic, brachial, or uterine vessels. We believe that in some instances this mechanism should be considered as an explanation for episodic neurological deficits seen in association with spinal AVM's.


1986 ◽  
Vol 65 (4) ◽  
pp. 484-489 ◽  
Author(s):  
Yu-quan Shi ◽  
Xian-cheng Chen

✓ A four-grade classification scheme for intracranial arteriovenous malformations (AVM's) is proposed. Grading is based on 1) the size of the AVM; 2) its location and depth; 3) its arterial supply; and 4) its venous drainage. Each of these aspects is divided into four grades with respect to the difficulty it poses for surgical excision. A description of the grading system and its application is given. This grading scale has been correlated with the operative morbidity and mortality in 100 cases of excised intracranial AVM's. The results show that the higher the grade of AVM, the greater the risk of surgical morbidity and mortality. This grading scale is simple and easy to apply. It can guide neurosurgeons in selecting AVM patients suitable for operation, in determining the best type of operation to perform, and in predicting operative difficulties as well as postoperative results.


1984 ◽  
Vol 60 (5) ◽  
pp. 1067-1069 ◽  
Author(s):  
Saburo Sakaki ◽  
Hitoshi Fujita ◽  
Kanehisa Kohno ◽  
Kenzo Matsuoka

✓ A case of an infratentorial dural arteriovenous malformation associated with an intracerebellar hematoma is reported. This malformation was fed by meningeal branches of the right vertebral artery and was drained exclusively by pial veins in the posterior fossa.


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