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

1996 ◽  
Vol 84 (1) ◽  
pp. 113-118 ◽  
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.

Etiological evaluation of dural arteriovenous malformations of the lateral and sigmoid sinuses based on histopathological examinations

1992 ◽  
Vol 76 (4) ◽  
pp. 600-606 ◽  
Author(s):  
Michiharu Nishijima ◽  
Akira Takaku ◽  
Shunro Endo ◽  
Naoya Kuwayama ◽  
Fumitomo Koizumi ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Arteriovenous Malformations ◽  
Dural Arteriovenous Fistula ◽  
Serial Sections ◽  
Content Type ◽  
Venous Sinuses ◽  
Sinus Wall ◽  
Fine Print

✓ Controversy persists concerning the pathogenesis of dural arteriovenous malformations (AVM's) and whether they are congenital or acquired. Furthermore, it remains undetermined whether the lesion is located in the sinus itself or within the sinus wall. In order to elucidate the pathogenesis of dural AVM's of the lateral and sigmoid sinuses, histopathological profiles of this disease were studied in serial sections of completely resected lesions from three patients. The essential lesion was histologically confirmed to be a dural arteriovenous fistula within the wall of the venous sinuses. The etiology process of this disease and its progression were evaluated.

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

2002 ◽  
Vol 97 (2) ◽  
pp. 467-470 ◽  
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.

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

1991 ◽  
Vol 75 (6) ◽  
pp. 947-949 ◽  
Author(s):  
Dong-Ik Kim ◽  
In-Sup Choi ◽  
Alex Berenstein
Keyword(s):  
Arteriovenous Fistula ◽  
Clinical Manifestation ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Spinal Dural Arteriovenous Fistula ◽  
Content Type ◽  
Repeat Angiography ◽  
Fine Print

✓ 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.

Stereotactic radiosurgery for dural arteriovenous fistula involving the superior sagittal sinus

2002 ◽  
Vol 97 ◽  
pp. 481-483 ◽  
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.

A Case of Sigmoid Sinus Dural Arteriovenous Fistula after Treated Cavernous Dural Arteriovenous Fistula

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 219-222 ◽  
Author(s):  
T. Makiuchi ◽  
K. Takasaki ◽  
M. Yamagami ◽  
H. Oda ◽  
K. Todoroki ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Sigmoid Sinus ◽  
External Carotid ◽  
Transvenous Embolization ◽  
Superior Ophthalmic Vein ◽  
Transfemoral Approach ◽  
Sinus Wall

Transvenous embolization has been recommended recently as the primary treatment for symptomatic cavernous dural arteriovenous fistula(dural AVF). We present a case of sigmoid sinus dural AVF which developed after transvenous embolization of cavernous dural AVF A 43-year-old man was admitted to our hospital because of left conjunctival chemosis, exophthalmus and abducens nerve palsy. Cerebral angiograms showed left cavernous dural AVF fed by the bilateral internal and external carotid arteries and draining into the enlarged left superior ophthalmic vein. Transfemoral approach in the cavernous sinus via inferior petrosal sinus (IPS) was difficult because of the occlusive change of IPS. Then, direct canulation of the left superior ophthalmic vein and transvenous embolization using interlocking detachable coils (IDC) were performed. Dural AVF and clinical symptoms were disappeard rapidly after embolization. Six months later, follow-up cerebral angiograms showed development of a dural AVF in the left sigmoid sinus. The pathogenesis of dural AVF remains unclear. We suggest that injury to the sinus wall during endovascular procedures may have provoked the development of dural AVF in our case. Clinical and angiographical follow-up are important.

Expression of angiogenic growth factors in dural arteriovenous fistula

1999 ◽  
Vol 91 (5) ◽  
pp. 781-786 ◽  
Author(s):  
Ryunosuke Uranishi ◽  
Hiroyuki Nakase ◽  
Toshisuke Sakaki
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Growth Factors ◽  
Growth Factor ◽  
Dural Arteriovenous Fistula ◽  
Sinus Thrombosis ◽  
Angiogenic Growth Factors ◽  
Connective Tissues ◽  
Content Type ◽  
Fine Print

Object. Although various mechanisms of the development of dural arteriovenous fistula (AVF) have been described, the exact course of its pathogenesis, including molecular processes mediating its genesis, is still unknown. Recently, the importance of sinus thrombosis and venous hypertension has been reported in experimental and clinical studies. Additionally, a role of angiogenic growth factors in the pathogenesis of vascular malformations of the central nervous system has been reported. In this study, the authors investigated the existence of sinus thrombosis in dural AVF and the expression of angiogenic growth factors (basic fibroblast growth factor [bFGF] and vascular endothelial growth factor [VEGF]) in nine patients with dural AVFs that were surgically resected.Methods. The authors examined histological features of dural AVFs that involved the transverse/sigmoid sinus in seven patients and the superior sagittal sinus in two. Sinus thrombosis was verified angiographically in seven cases and histologically in all cases. In surgically resected specimens the angiogenic growth factors bFGF and VEGF were examined immunohistochemically in nine patients with dural AVFs, with five dural sinuses from cadavers with unrelated central nervous system diseases serving as a normal control group. The media and perivascular connective tissues of the arteries in the wall of the normal dural sinuses stained faintly for bFGF; on the other hand, the expression of VEGF was not detected. In all patients with dural AVFs, the thick wall of the dural sinus stained strongly for bFGF, mainly in the subendothelial layer and media of the strongly proliferative vessels in the sinus wall, in addition to the perivascular connective tissues. In all nine cases VEGF was expressed in the endothelium of the sinus and perivascular connective tissues. In two cases, VEGF was expressed in many capillaries proliferating in the granulation-like tissues in sinuses that were obliterated by organized thrombi.Conclusions. It is concluded that the pathogenesis of dural AVF is still unknown, but that angiogenic growth factors, which might be produced by the healing process due to sinus thrombosis, may participate in the genesis of dural AVF. Understanding the mechanism of molecular pathogenesis in the development of dural AVF might aid in the establishment of a new therapeutic strategy for this dynamic vascular disease.

A cervical dural arteriovenous fistula in a patient presenting with radiculopathy

1996 ◽  
Vol 84 (1) ◽  
pp. 119-123 ◽  
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.

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

1999 ◽  
Vol 90 (5) ◽  
pp. 964-969 ◽  
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.

Selective transvenous liquid embolization of a Type 1 dural arteriovenous fistula at the junction of the transverse and sigmoid sinuses

2000 ◽  
Vol 92 (6) ◽  
pp. 1045-1049 ◽  
Author(s):  
Kazuhiro Ohtakara ◽  
Kenichi Murao ◽  
Kenji Kawaguchi ◽  
Yoshihiro Kuga ◽  
Tadashi Kojima ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Skull Fracture ◽  
Venous Access ◽  
Extradural Hematoma ◽  
Content Type ◽  
Transvenous Approach ◽  
Fine Print

✓ The authors describe the case of a 51-year-old man with a Type 1 dural arteriovenous fistula (AVF) located at the junction of the transverse and sigmoid sinuses. The dural AVF developed after the patient underwent a craniotomy for an acute extradural hematoma. The patient suffered pulsatile tinnitus 3 months after surgery. After several attempts at transarterial embolization (TAE), the venous channel located close to the skull fracture was accessed via a transfemoral—transvenous approach and was embolized by administering a liquid nonadhesive agent. Successful embolization of the dural AVF was achieved both clinically and radiologically without causing considerable hemodynamic alterations. This procedure, either alone or combined with TAE, would seem to be an alternative treatment for dural AVFs in this location, without causing compromise of flow within the affected sinuses, when selective venous access is available.

Transarterial approach for selective intravenous coil embolization of a benign dural arteriovenous fistula

2003 ◽  
Vol 99 (4) ◽  
pp. 775-778 ◽  
Author(s):  
Koji Tokunaga ◽  
Krisztina Barath ◽  
Jean-Baptiste Martin ◽  
Daniel A. Rüfenacht
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Coil Embolization ◽  
Dural Arteriovenous Fistula ◽  
Venous Reflux ◽  
Content Type ◽  
Dural Sinuses ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Fine Print

✓ Transarterial particulate embolization is indicated for benign intracranial dural arteriovenous fistulas (DAVFs) that have no dangerous venous reflux. This treatment, however, does not cure these lesions. In this case report the authors describe a spontaneously occurring DAVF that was treated by implanting coils through a transarterial microcatheter into the affected venous channel. The channel was separate from the normal dural sinuses. The pathological architecture of the fistula and the usefulness of this approach are discussed.

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