1/299. Tentorial dural arteriovenous fistula obliterated using the petrosal approach.BACKGROUND: Tentorial dural arteriovenous fistulas (AVFs) are uncommon lesions usually treated surgically using a subtemporal exposure with division of the tentorium. This exposure requires significant retraction of the temporal lobe and has the possibility of significant arterialized venous bleeding if a draining vein is accidentally cut during division of the tentorium. skull base surgical techniques may provide alternate approaches for the surgical treatment of tentorial dural AVFs. methods: A tentorial dural arteriovenous fistula supplied by the tentorial artery and drained by the petrosal vein was exposed and obliterated using the petrosal (subtemporal-presigmoid) approach. RESULTS: The petrosal approach allowed the exposure and division of the superior petrosal sinus and tentorium with direct visualization of the supratentorial and the infratentorial compartments, avoiding accidental damage to the draining veins. The dural fistula was easily obliterated after its venous drainage was interrupted and the tentorial artery occluded. CONCLUSIONS: Tentorial dural AVFs can be safely treated with interruption of the venous drainage. The exposure can be enhanced with a petrosal approach, decreasing the possibility of uncontrolled bleeding during the procedure.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
2/299. Development of a dural arteriovenous fistula around the jugular valve after transvenous embolization of cavernous dural arteriovenous fistula.BACKGROUND: Endovascular therapy for dural arteriovenous fistulas (DAVFs) is not without any risks, although it has been generally accepted to be a safe procedure. In this paper, we report a very rare complication: metachronous DAVF around a jugular valve 4 months after transvenous embolization. CASE DESCRIPTION: A 43-year-old woman presented with left proptosis, chemosis, and double vision. cerebral angiography demonstrated a left cavernous DAVF. The patient's symptoms resolved almost completely after embolization with platinum coils via the superior ophthalmic vein. Four months later, angiography revealed a metachronous DAVF around a jugular valve. CONCLUSION: To our knowledge, only four such cases have been reported in the literature. Careful follow-up of patients treated with transvenous embolization and accumulation of such cases are needed to understand the pathogenesis of multiple DAVFs.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
3/299. Carotid artery fistula after cataract surgery.To determine carotid cavernous fistula associated with choroidal detachment after cataract surgery. A 77-year-old woman underwent cataract surgery in both eyes. Postoperatively, proptosis and dilation of episcleral vessels in her left eye occurred and gradually increased. One month later, choroidal detachment developed in her left eye. Computed tomography showed an enlarged superior ophthalmic vein. Selected cerebral angiography showed fistulas between the megingeal branches of both the internal and external carotid arteries and the cavernous sinus. After the neurosurgical treatment, these symptoms disappeared. The development of carotid cavernous fistula after cataract surgery, as demonstrated in our patient, may be uncommon. [Ophthalmic Surg lasers 1998;30:160-162.] Carotid cavernous fistula (CCF) is an abnormal communication between the internal carotid artery and the cavernous sinus. Ocular manifestation of the fistula includes proptosis, pulsation of the globe, orbital bruit, episcleral vein dilation, and chemosis. CCF is divided into spontaneous or traumatic by cause and direct or dural by angiographic findings. To our knowledge, CCF development after cataract surgery may be uncommon. We recently examined a patient with such a condition.- - - - - - - - - - ranking = 0.11111111111111keywords = dura (Clic here for more details about this article) |
4/299. Dural arteriovenous fistula of the cervical spine presenting with subarachnoid hemorrhage.We describe a case of dural arteriovenous fistula (DAVF) presenting with subarachnoid hemorrhage (SAH). The diagnosis of DAVF was based on spinal angiography. A review of the literature revealed that five of 13 previously reported DAVFs of the cervical spine were accompanied by SAH. SAH has not been observed in DAVFs involving other segments of the spinal canal.- - - - - - - - - - ranking = 0.11111111111111keywords = dura (Clic here for more details about this article) |
5/299. Intrahepatic arterioportal fistula: gadolinium-enhanced 3D magnetic resonance angiography findings and angiographic embolization with steel coils.We describe a case of a 59-year-old patient with intrahepatic arterioportal fistula secondary to blunt trauma sustained by a motor vehicle accident 36 years earlier. The fistula was demonstrated 36 years after the accident in a clinical work-up for diarrhea of 1 month's duration, using contrast enhanced three-dimensional breath-hold MRA. A communication between the dilated portal vein and dilated hepatic artery was shown at the level of distal branches. After subsequent demonstration by conventional angiography, the fistula was embolized using steel coils. Following the therapeutic intervention, the patient's diarrhea ceased.- - - - - - - - - - ranking = 0.11111111111111keywords = dura (Clic here for more details about this article) |
6/299. Spinal dural arteriovenous fistula with an associated feeding artery aneurysm: case report.OBJECTIVE AND IMPORTANCE: A case of a spinal dural arteriovenous fistula (DAVF) with two associated feeding artery aneurysms is reported. Intradural spinal arteriovenous malformations have been associated with aneurysms that present with subarachnoid hemorrhage and with venous varices that produce mass effect, but spinal DAVFs have not previously been described in association with feeding artery aneurysms. CLINICAL PRESENTATION: A 71-year-old man presented with progressive spastic paraparesis, constipation, and overflow incontinence. magnetic resonance imaging demonstrated a spinal vascular lesion and venous ischemia in the lower spinal cord. Diagnostic spinal angiography revealed a DAVF originating from the left T11 radicular artery and having the unusual feature of two proximal feeding artery aneurysms. INTERVENTION: The patient deteriorated neurologically after undergoing angiography, prompting emergent surgery. The DAVF was resected through a T11 transpedicular approach. One aneurysm was dolichoectatic and therefore unclippable, requiring proximal occlusion of the parent artery after establishing tolerance of test occlusion using somatosensory evoked potentials; the second aneurysm was adjacent to the fistula and was resected with the DAVF. CONCLUSION: Feeding artery aneurysms in association with spinal DAVFs have not been previously reported. They present additional risk to patients and, with simple modifications of the standard operative approaches, can easily be treated as part of the surgery for the DAVF.- - - - - - - - - - ranking = 0.66666666666667keywords = dura (Clic here for more details about this article) |
7/299. Transumbilical embolization of a congenital dural arteriovenous fistula at the torcular herophili in a neonate. Case report.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 trans-umbilical venous intervention has been reported in the literature.- - - - - - - - - - ranking = 0.77777777777778keywords = dura (Clic here for more details about this article) |
8/299. Severe cerebral venous sinus thrombosis and dural arteriovenous fistula in an infant with protein s deficiency.A 12-month-old infant presented with cerebral seizures and neurological deficits. MRI scan of the brain and angiography showed massive cerebral venous sinus thrombosis complicated by a dural arteriovenous fistula. Subsequent clotting analysis revealed a protein s deficiency. Screening for inherited coagulation inhibitor deficiency is recommended in children with unexplained or atypical thrombotic events.- - - - - - - - - - ranking = 0.55555555555556keywords = dura (Clic here for more details about this article) |
9/299. Spinal dural arteriovenous fistulae draining to the anterior spinal vein: angiographic diagnosis.OBJECTIVE: To describe and present atypical spinal dural arteriovenous fistulae (SDAVFs) that drain into the anterior spinal vein (ASV) and thus cause some degree of difficulty in differentiating the anterior spinal artery from the ASV. methods: A retrospective review of 80 selective spinal angiography procedures (with or without endovascular treatment) performed on SDAVFs since 1980 identified three cases in which the venous drainage was into a dilated ASV via a radicular vein. The patients included two men and one woman, ranging in age from 55 to 82 years (mean age, 71 yr), all of whom presented with mild to severe progressive paraparesis and sensory disturbance. RESULTS: The appearance of the venous drainage mimicked that of the usual hairpin configuration of the radiculomedullary artery and therefore caused diagnostic difficulty. There are no characteristic clinical features that differentiate this form of SDAVF from the usual type of SDAVF. The angiographic criteria for identification of the ASV draining an SDAVF include the demonstration of the branching of the ASV and its drainage into the epidural vein, opacification of other medullary veins connected with the ASV, recognition of distortion of the hairpin shape, and the identification of the anterior spinal artery at the segment where the ASV is opacified. Two patients were treated with embolization and one with surgery. All patients improved after the treatment. CONCLUSION: Before performing endovascular treatment, thorough spinal angiography with an appropriate field of view must be performed to identify this unusual type of SDAVF.- - - - - - - - - - ranking = 0.66666666666667keywords = dura (Clic here for more details about this article) |
10/299. Multiple dural arteriovenous shunts in a 5-year-old boy.We describe a rare case of multiple dural arteriovenous shunts (DAVSs) in a 5-year-old boy. MR imaging performed at 1 year of age showed only a dilated anterior part of the superior sagittal sinus; however, angiography at 5 years of age revealed an infantile-type DAVS there and two other DAVSs of the adult type. The pathophysiological evolution of DAVSs in children and their treatment strategies are discussed.- - - - - - - - - - ranking = 0.55555555555556keywords = dura (Clic here for more details about this article) |
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