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Pial fistula

Takahiro Osada, Timo Krings
BACKGROUND: Pial arterial supplies are sometimes found in patients with dural arteriovenous fistulas (DAVFs), though their characteristics have rarely been clarified. OBJECTIVE: To investigate the characteristics of pial arterial supplies in DAVFs and to discuss their pathophysiology and treatment. METHODS: Two hundred four consecutive patients with intracranial DAVFs over 11 yr were retrospectively reviewed. Clinical factors and radiological findings, including the presence of pial arterial supplies, were evaluated...
March 8, 2018: Neurosurgery
H G Kortman, I Boukrab, G Bloemsma, J P Peluso, M Sluzewski, B van der Pol, G N Beute, C B Majoie, W J van Rooij
Objective: Tentorial dural arteriovenous fistulas usually drain into cortical veins and often present with hemorrhage. Treatment goal is occlusion of the draining vein, either by surgery or endovascular techniques. We present the multimodality treatment results of 12 patients with tentorial dural arteriovenous fistulas. Materials and Methods: Between January 2007 and January 2017, 12 consecutive patients with tentorial dural arteriovenous fistulas were treated. There were 11 men and 1 woman with a mean age of 62 years (range 44-85)...
December 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Andrea Rosi, Arturo Consoli, Stéphanie Condette-Auliac, Oguzhan Coskun, Federico Di Maria, Georges Rodesch
BACKGROUND: Spinal cord arteriovenous shunts (scAVSs) are a group of lesions located in the spinal cord itself or in the surrounding structures. The most common scAVSs are spinal dural arteriovenous fistulas (sDAVFs), which are acquired lesions. The pathogenesis of sDAVFs involves thrombosis and venous hypertension as trigger factors. Intradural scAVSs such as spinal cord arteriovenous nidus type malformations (AVMs) and pial arteriovenous fistulas are less common than sDAVFs and are considered to have a so-called 'congenital' origin...
January 19, 2018: Journal of Neurointerventional Surgery
Shun-Bao Xin, Guang-Bin Wang, Wen-Juan Liu, Qiang Liu
No abstract text is available yet for this article.
December 14, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Kiranbharath Venkatesulu, Amar Nandhakumar, Mathew Cherian, Pankaj Mehta, Nithiyanandhan Palanisamy
No abstract text is available yet for this article.
December 12, 2017: Journal of Neurosurgical Anesthesiology
Shriram Varadharajan, Arvinda Hanumanthapura Ramalingaiah, Jitender Saini, Arun Kumar Gupta, B Indira Devi, Ullas V Acharya
Precipitating hydrophobic injectable liquid (PHIL) is a newly available liquid embolic agent for endovascular therapy. It is nonadhesive and composed of a biocompatible polymer dissolved in dimethyl sulfoxide solvent and bonded covalently with iodine. In this report, the authors present their preliminary experience using PHIL in the treatment of intracranial vascular shunts. Between July 2015 and December 2015, 11 patients underwent endovascular embolization using the PHIL embolic agent. Five patients had arteriovenous malformations, 4 had dural arteriovenous fistulas, 1 patient had a carotid-cavernous fistula, and 1 patient had a pial arteriovenous fistula...
December 1, 2017: Journal of Neurosurgery
Atul Goel, Sonal Jain, Abhidha Shah, Survendra Rai, Sandeep Gore, Pralhad Dharurkar
OBJECTIVE: The authors report their successful experience of treating 14 cases of pial arteriovenous fistula (PAVF) by direct surgery. METHODS: During the period January 2010 to April 2017, 14 patients with PAVF were treated by surgery. Only those patients were selected who had a single arterial feeding channel. There were 9 male patients and 5 female patients, and their ages ranged from 5 to 53 years (average, 19 years). Ten patients were younger than 20 years of age...
February 2018: World Neurosurgery
Yen-Heng Lin, Yu-Fen Wang, Hon-Man Liu, Chung-Wei Lee, Ya-Fang Chen, Hong-Jen Hsieh
PURPOSE: Computed tomography angiography (CTA) and magnetic resonance imaging/angiography (MRI/MRA) are used for the diagnosis of intracranial dural arteriovenous fistulas (DAVFs). The purpose of this study was to compare the diagnostic accuracy of CTA and magnetic resonance imaging/angiography (MRI/MRA) for detection of cortical venous reflux (CVR) in intracranial DAVFs. METHODS: The records of patients with angiography-confirmed intracranial DAVFs who also received CTA and MRI/MRA from January 2008 to July 2016 were reviewed...
January 2018: Neuroradiology
Guillaume Saliou, Mélanie Eyries, Marta Iacobucci, Jean-François Knebel, Marie-Christine Waill, Florence Coulet, Augustin Ozanne, Florent Soubrier
OBJECTIVE: To assess the spectrum of genetic anomalies in a cohort of children presenting at least one cerebral or spinal pial arteriovenous fistula (AVF), and to describe their clinical characteristics. METHODS: From 1988 to 2016, all consecutive patients with at least one cerebral or spinal pial AVF were screened for genetic disease. All patients aged <18 years were included. Symptoms associated with AVF were recorded: heart failure, neurological deficit/seizure, and hemorrhage...
December 2017: Annals of Neurology
Michael George Zaki Ghali
Vein of Galen aneurysmal malformations (VGAMs) are complex vascular lesions. Their etiopathogenesis is extensively debated and remains poorly understood. Strictly speaking, true VGAMs are Galenic pial arteriovenous fistulas. They are believed to arise in utero and are contended to drain either into the true vein of Galen or the median prosencephalic vein of Markowski. Several classification systems have been proposed and are widely used. With the advent of endovascular therapy, precise understanding of the angioarchitecture is critical for management and therapeutic decision making...
October 30, 2017: Clinical Anatomy
S W Hetts, A Yen, D L Cooke, J Nelson, P Jolivalt, J Banaga, M R Amans, C F Dowd, R T Higashida, M T Lawton, H Kim, V V Halbach
BACKGROUND AND PURPOSE: Although intracranial dural arteriovenous fistulas are principally supplied by dural branches of the external carotid, internal carotid, and vertebral arteries, they can also be fed by pial arteries that supply the brain. We sought to determine the frequency of neurologic deficits following treatment of intracranial dural arteriovenous fistulas with and without pial artery supply. MATERIALS AND METHODS: One hundred twenty-two consecutive patients who underwent treatment for intracranial dural arteriovenous fistulas at our hospital from 2008 to 2015 were retrospectively reviewed...
December 2017: AJNR. American Journal of Neuroradiology
J Vilalta, S Nunez-Videgaray, D Gandara, A Rodriguez-Hernandez, F Arikan
No abstract text is available yet for this article.
September 16, 2017: Revista de Neurologia
Masafumi Hiramatsu, Kenji Sugiu, Tomoya Ishiguro, Hiro Kiyosue, Kenichi Sato, Keisuke Takai, Yasunari Niimi, Yuji Matsumaru
OBJECTIVE The aim of this retrospective multicenter cohort study was to assess the details of the angioarchitecture of arteriovenous fistulas (AVFs) at the craniocervical junction (CCJ) and to determine the associations between the angiographic characteristics and the clinical presentations and outcomes. METHODS The authors analyzed angiographic and clinical data for patients with CCJ AVFs from 20 participating centers that are members of the Japanese Society for Neuroendovascular Therapy (JSNET). Angiographic findings (feeding artery, location of AV shunt, draining vein) and patient data (age, sex, presentation, treatment modality, outcome) were tabulated and stratified based on the angiographic types of the lesions, as diagnosed by a member of the CCJ AVF study group, which consisted of a panel of 6 neurointerventionalists and 1 spine neurosurgeon...
September 1, 2017: Journal of Neurosurgery
Lei Huang, Liang Ge, Gang Lu, Daoying Geng, Xiaolong Zhang, Wenjie Cao
BACKGROUND: The association between venous reflux patterns with aggressive intracranial lesions (AILs), including intracranial edema (IE), intraparenphymal hemorrhage (IPH), and subarachnoid hemorrhage (SAH), has not been well established in cranial dural arteriovenous fistulas (DAVFs). We propose an updated classification system based on venous drainage. METHODS: We retrospectively assessed the catheter angiography findings of venous drainage patterns. Cranial DAVFs with no reflux flow and those with reflux flow drainage into the sinus only, the bridge vein only, the bridge vein and pial vein, and the sinus, bridge vein, and pial vein were designated as types 1, 2, 3, 4, and 5, respectively...
November 2017: World Neurosurgery
P Lylyk, J Chudyk, C Bleise, C Serna Candel, M Aguilar Pérez, H Henkes
Background In large-caliber pial macrofistulae (pMF), the combination of high blood flow velocity and large efferent artery diameter makes control over the endovascular vessel occlusion difficult and may result in the inadvertent venous passage of occlusive devices or embolic agents. Case descriptions Patient 1: A 27-year-old man presented with headache and ataxia. An infratentorial pMF supplied by both superior cerebellar arteries with venous ectasia was found. The first treatment attempt using balloons and coils failed since the position of either device could not be controlled because of a distal diameter of the feeding artery of 8 mm...
December 2017: Interventional Neuroradiology
Christopher Elia, Tanya Minasian, Mazen Noufal, Vaninder Chhabra
BACKGROUND: Vascular anomalies in the form of dural arteriovenous fistulas (DAVFs), arteriovenous malformations, and aneurysms are well described in the literature. Pial arteriovenous fistulas (PAVFs) are described to a lesser extent in the literature. When these anomalies are combined, diagnosis and treatment become complex. CASE DESCRIPTION: A 55-year-old man presented with PAVF/DAVF with a ruptured flow-related aneurysm in the distal left posterior inferior cerebellar artery, which required surgical clipping and disconnection...
September 2017: World Neurosurgery
Alessandro Pedicelli, Marta Iacobucci, Paolo Frassanito, Emilio Lozupone, Gabriele Masselli, Concezio Di Rocco, Cesare Colosimo
BACKGROUND: Intracranial pial arteriovenous fistulas (PAVFs) are direct communications between the arterial and venous system of the brain, with the characteristic absence of a plexiform nidus, as seen in the classic cerebral arteriovenous malformations. These vascular malformations, usually occurring in the pediatric population, very rarely are diagnosed in utero, because of a lack of understanding of the condition and because they may be hard to visualize. CASE DESCRIPTION: We report a rare case of a mass-effect PAVF diagnosed with fetal magnetic resonance imaging, involving the right cerebral hemisphere, fed by a pericallosal artery and associated with a giant venous dilatation...
August 2017: World Neurosurgery
A Jessey Chugh, Asim Shahid, Sunil Manjila, Deepak Gulati, Nicholas C Bambakidis
We present case reports of 2 pediatric patients who were both found to have pial arteriovenous fistulas (AVFs) with subsequent genetic analysis revealing mutations in the RASA1 gene. Considering their family history of distinct cutaneous lesions, these mutations were likely inherited as opposed to de novo mutations. Patient 1 had large capillary malformations on the left side of the face and neck, associated with macrocephaly, and presented at the age of 32 months with speech delay, right-sided weakness, and focal seizures involving the right side of the body...
2017: Pediatric Neurosurgery
Kenichi Sato, Yasushi Matsumoto, Hidenori Endo, Teiji Tominaga
We report a case of tentorial dural arteriovenous fistula (DAVF) with a severe intracranial hemorrhage occurring after Onyx embolization. A 40-year-old man presented with an asymptomatic tentorial DAVF on angiography. Transarterial embolization with Onyx was performed via the middle meningeal artery, and the cast filled the fistula itself and its proximal draining vein. Postoperative angiography confirmed complete occlusion of the DAVF. A computed tomography scan performed immediately after the procedure demonstrated an acute subdural hematoma with the temporal hemorrhage...
June 2017: Interventional Neuroradiology
Cristina Martínez-Payo, Javier Sancho Saúco, Maria Miralles, Tirso Pérez Medina
Pial arteriovenous (AV) fistulae have rarely been diagnosed in utero. They are characterized by one or more pial arteries flowing directly into a cortical vein without any shunt or interposed capillary bed. In the fetus and the newborn up to 2 years of age, the most common clinical manifestation is heart failure resulting from fistula overload. Later on, hydrocephalus, focal neurologic deficits, headaches, seizures, and cerebral hemorrhage are the most common manifestations. We present a case of nongalenic pial AV fistula diagnosed in the 25th week of pregnancy, which resulted in intrauterine fetal death due to congestive heart failure...
April 3, 2017: Journal of Clinical Ultrasound: JCU
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