Decreased Superior Sagittal Sinus Diameter and Jugular Bulb Narrowing Are Associated with Poor Clinical Outcome in Vein of Galen Arteriovenous Malformation

Abstract The management of the case of a 9-year-old boy with progressive cognitive impairment due to arteriovenous fistulae at the apex of the inferior sagittal sinus is reported. This represents a unique location for an extraparenchymal deep central arteriovenous malformation. The patient underwent staged ablation of the lesion by surgery. The postoperative course was complicated by expansion of an aneurysmal vein of Galen undergoing thrombosis and hyperperfusion syndrome, but the patient ultimately made a satisfactory recovery.

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Arteriovenous fistula with associated aneurysms coexisting with dural arteriovenous malformation of the anterior inferior falx

Journal of Neurosurgery ◽

10.3171/jns.1999.91.2.0303 ◽

1999 ◽

Vol 91 (2) ◽

pp. 303-307 ◽

Cited By ~ 28

Author(s):

John Ratliff ◽

Rand M. Voorhies

Keyword(s):

Arteriovenous Malformation ◽

Arteriovenous Fistula ◽

Left Vertebral Artery ◽

External Carotid ◽

Vein Of Galen ◽

Dural Arteriovenous Malformation ◽

Content Type ◽

Sagittal Sinus ◽

Dural Avm ◽

Fine Print

✓ 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.

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Scalp Arteriovenous Malformation Draining into the Superior Sagittal Sinus Associated with an Intracranial Arteriovenous Malformation: Just a Coincidence? Case Report

Neurosurgery ◽

10.1227/01.neu.0000043934.85424.a2 ◽

2003 ◽

Vol 52 (2) ◽

pp. 440-443 ◽

Cited By ~ 12

Author(s):

Giuseppe Lanzino ◽

Emiliano Passacantilli ◽

G. Michael Lemole ◽

Cameron McDougall ◽

Robert F. Spetzler

Keyword(s):

Arteriovenous Malformation ◽

Clinical Evidence ◽

Clinical Observation ◽

Superior Sagittal Sinus ◽

Venous Pressure ◽

Experimental Studies ◽

Hemodynamic Changes ◽

Intracranial Arteriovenous Malformation ◽

Sagittal Sinus ◽

Hemodynamic Characteristics

Abstract OBJECTIVE AND IMPORTANCE Recent experimental and clinical evidence suggests that hemodynamic changes in the venous system can induce the formation of new arteriovenous malformations (AVMs). In a rat model, increased venous pressure induces the formation of soft tissue and dural AVMs. We report a clinical observation that may support these data. CLINICAL PRESENTATION A 4-year-old boy with a midline scalp AVM draining into the superior sagittal sinus had an associated intracranial/parenchymal AVM. The cerebral AVM increased venous pressure in the superior sagittal sinus as revealed by angiography. INTERVENTION The scalp AVM was resected, and the intracranial AVM was treated by use of the gamma knife. CONCLUSION On the basis of reported experimental data and the morphological and hemodynamic characteristics in this patient's two lesions, we suggest that the scalp AVM might have been induced by hypertension in the superior sagittal sinus. This clinical observation supports the notion suggested by experimental studies that hemodynamic changes can induce the formation of associated AVMs.

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Unilateral proptosis and chemosis caused by dural arteriovenous malformation of the superior sagittal sinus

British Journal of Neurosurgery ◽

10.1080/02688699845375 ◽

1998 ◽

Vol 12 (2) ◽

pp. 176-178 ◽

Cited By ~ 6

Author(s):

A. KUROSU ◽

Y. IIZUKA ◽

K. SATO

Keyword(s):

Arteriovenous Malformation ◽

Superior Sagittal Sinus ◽

Dural Arteriovenous Malformation ◽

Sagittal Sinus ◽

Unilateral Proptosis

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Selective Transvenous Coil Embolization of Dural Arteriovenous Fistula

Interventional Neuroradiology ◽

10.1177/15910199070130s118 ◽

2007 ◽

Vol 13 (1_suppl) ◽

pp. 123-130 ◽

Cited By ~ 3

Author(s):

T. Yoshioka ◽

N. Kitagawa ◽

H. Yokoyama ◽

I. Nagata

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Venous Return ◽

Superior Sagittal Sinus ◽

Venous Drainage ◽

Vein Of Galen ◽

Selective Embolization ◽

Sagittal Sinus ◽

Basal Vein Of Rosenthal ◽

Great Vein

We herein report three cases of dural arteriovenous fistula (DAVF) in which the venous outlet immediately adjacent to the fistula was selectively embolized. Case 1: A 69-year-old man presented with a subarachnoid hemorrhage (SAH). Angiography demonstrated a DAVF in the left superior petrous sinus. Case 2: A 59-year-old woman presented with dizziness. Angiography demonstrated a DAVF adjacent to great vein of Galen. The DAVF drained through the great vein of Galen with retrograde leptomeningeal venous drainage (RLVD). The basal vein of Rosenthal was enhanced from the great vein of Galen. Case 3: A 51-year-old man presented with an occipital seizure. Angiography demonstrated a DAVF adjacent to the left side of the superior sagittal sinus with RLVD. All three cases were successfully treated by the selective embolization of the venous outlet immediately adjacent to the fistula. Therefore, selective embolization preserved normal venous return.

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Dural Arteriovenous Malformation Associated with Occlusion of the Superior Sagittal Sinus

Neurologia medico-chirurgica ◽

10.2176/nmc.31.41 ◽

1991 ◽

Vol 31 (1) ◽

pp. 41-44 ◽

Cited By ~ 7

Author(s):

Toshihiro MINETA ◽

Kouzou FUKUYAMA ◽

Hisao KOGA ◽

Shun-ichi MATSUMOTO ◽

Takashi KISHIKAWA ◽

...

Keyword(s):

Arteriovenous Malformation ◽

Superior Sagittal Sinus ◽

Dural Arteriovenous Malformation ◽

Sagittal Sinus

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Primary empty sella in association with superior sagittal sinus thrombosis and dural arteriovenous malformation

Journal of Neurosurgery ◽

10.3171/jns.1994.81.1.0122 ◽

1994 ◽

Vol 81 (1) ◽

pp. 122-125 ◽

Cited By ~ 3

Author(s):

Toshihiko Haisa ◽

Shinichi Yoshida ◽

Toshiyuki Ohkubo ◽

Kohki Yoshikawa ◽

Tohru Machida

Keyword(s):

Arteriovenous Malformation ◽

Medroxyprogesterone Acetate ◽

Superior Sagittal Sinus ◽

Sinus Thrombosis ◽

Empty Sella ◽

Dural Arteriovenous Malformation ◽

Sagittal Sinus ◽

Sagittal Sinus Thrombosis ◽

Superior Sagittal Sinus Thrombosis ◽

Primary Empty Sella

✓ A 61-year-old woman under treatment with oral medroxyprogesterone acetate following surgery for breast cancer developed diplopia and papilledema due to raised intracranial pressure (ICP). Radiological studies disclosed an empty sella turcica, a dural arteriovenous malformation (AVM), and superior sagittal sinus thrombosis. The sinus thrombosis was considered to have been a side effect of the medroxyprogesterone acetate medication. The association between a primary empty sella and raised ICP is briefly discussed, along with the cause-and-effect relationship between a dural AVM and venous sinus thrombosis.

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Intraoperative Ultrasound Navigation with Doppler Function to Guide Arteriovenous Malformation Resection: 3-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opz006 ◽

2019 ◽

Vol 17 (4) ◽

pp. E162-E163

Author(s):

Marcos Dellaretti ◽

Daniel Espindola Ronconi

Keyword(s):

Arteriovenous Malformation ◽

Doppler Ultrasound ◽

Superior Sagittal Sinus ◽

Intraoperative Ultrasound ◽

Complete Resection ◽

Sensory Cortex ◽

Cortical Mapping ◽

3 Dimensional ◽

Sagittal Sinus ◽

The Right

Abstract Intraoperative ultrasound navigation was initially introduced in the neurosurgical field for brain tumor surgery and was then extended to arteriovenous malformation surgery with good success. This tool provides real-time intraoperative images.1 Moreover, Doppler ultrasound permits early identification of feeding arteries and supplies the surgeon with a global impression of the flow dynamics.2 A further use of doppler is to check for residual nidus. Other advantages are the capacity to identify intracerebral hemorrhage.2 In this video, we demonstrate the case of a 15-yr-old patient who presented intracranial hemorrhage. Magnetic resonance imaging revealed the presence of left frontoparietal hematoma associated with an image suggestive of cerebral arteriovenous malformation (AVM). Arteriography confirmed the diagnosis of AVM fed by branches of the anterior cerebral and superficial drainage for the superior sagittal sinus. The patient was placed in dorsal decubitus with his head turned to the right and a left parietal-frontal craniotomy was performed. After the dura mater was opened, cortical mapping was performed to locate the motor and sensory cortex. After the mapping, ultrasound with doppler was performed to locate the AVM and the hematoma and determine its relation to the motor and sensory cortex. At the end of the surgery, doppler ultrasound was used again to ensure complete resection of the AVM. Intraoperative Ultrasound navigation with doppler is an inexpensive technology that can be used in the treatment of AVMs, especially in the subcortex, as it assists in locating the nidus and confirms its complete resection.

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Total recanalization of a spontaneously thrombosed arteriovenous malformation

Journal of Neurosurgery ◽

10.3171/jns.1995.82.3.0506 ◽

1995 ◽

Vol 82 (3) ◽

pp. 506-508 ◽

Cited By ~ 19

Author(s):

Tohru Mizutani ◽

Hiroshi Tanaka ◽

Tohru Aruga

Keyword(s):

Arteriovenous Malformation ◽

Superior Sagittal Sinus ◽

Spontaneous Thrombosis ◽

Left Frontal Lobe ◽

Content Type ◽

Sagittal Sinus ◽

First Case ◽

Inferior Aspect ◽

Follow Up Care

✓ The authors describe what they believe to be the first case of an asymptomatic, totally recanalized arteriovenous malformation (AVM) demonstrated by angiography 31 months after complete spontaneous thrombosis. The AVM, which initially became symptomatic with bleeding, had a 2-cm diameter nidus that was located within the inferior aspect of the left frontal lobe and was fed by branches from the left anterior cerebral and anterior ethmoid arteries. A single draining vessel flowed from the nidus into the anterior superior sagittal sinus. The AVM was surgically extirpated after recanalization. The authors stress the necessity for follow-up care for angiographically “cured” AVMs.

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