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Jinlu Yu, Yunbao Guo, Baofeng Xu, Kan Xu
The middle meningeal artery (MMA) is a very important artery in neurosurgery. Many diseases, including dural arteriovenous fistula (DAVF), pseudoaneurysm, true aneurysm, traumatic arteriovenous fistula (AVF), moyamoya disease (MMD), recurrent chronic subdural hematoma (CSDH), migraine and meningioma, can involve the MMA. In these diseases, the lesions occur in either the MMA itself and treatment is necessary, or the MMA is used as the pathway to treat the lesions; therefore, the MMA is very important to the development and treatment of a variety of neurosurgical diseases...
2016: International Journal of Medical Sciences
Yu-Ching Cheng, Hung-Chieh Chen, Chen-Hao Wu, Yi-Ying Wu, Ming-His Sun, Wen-Hsien Chen, Jyh-Wen Chai, Clayton Chi-Chang Chen
BACKGROUND: Traditional digital subtraction angiography (DSA) is currently the gold standard diagnostic method for the diagnosis and evaluation of cerebral arteriovenous malformation (AVM) and dural arteriovenous fistulas (dAVF). OBJECTIVES: The aim of this study was to analyze different less invasive magnetic resonance angiography (MRA) images, time-resolved MRA (TR-MRA) and three-dimensional time-of-flight MRA (3D TOF MRA) to identify their diagnostic accuracy and to determine which approach is most similar to DSA...
April 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
Naoya Kuwayama
BACKGROUND AND PURPOSE: There are few reports describing the prevalence of dural arteriovenous fistulas (dAVFs). We conducted a nation-wide retrograde survey on the clinical frequency and the status of treatment of dAVFs in Japan. METHODS: The first questionnaire was sent to 1,236 certified neurosurgery clinics in Japan to ask about the number of patients treated and the location of dAVF during the 5 years from 1998 to 2002. The second questionnaire was sent to 102 large-volume centers to ask the patients' ages, gender, location of the fistula, clinical presentation, treatment modalities, clinical and radiological results, and recurrence...
2016: Acta Neurochirurgica. Supplement
Alessandro Bertuccio, Chiara Robba, Giannantonio Spena, Pietro Primo Versari
INTRODUCTION: Dural arteriovenous fistulas (DAVFs) is a challenging condition in vascular neurosurgery. Development of new endovascular techniques has progressively modified treatment strategies; however, surgery is still considered a valid option of treatment of this pathology. MATERIALS AND METHODS: From a retrospective analysis of our database, we selected 107 patients who underwent surgical treatment for DAVFs. Patients were grouped into five categories according to the Borden and Cognard classifications...
2016: Acta Neurochirurgica. Supplement
Michihiro Tanaka
BACKGROUND: The distribution of intracranial dural AVFs (DAVFs) may be affected by the embryological bony structures that consist of membranous bone and endochondral bone. METHODS: We retrospectively analyzed the distribution of the shunt points in 58 consecutive cases of DAVFs. Shunt points were identified with selective digital subtraction angiography, high-resolution cone beam computed tomography (CT), or three-dimensional rotation angiography. All the shunt points were plotted on the map of the skull base in relation to the topography of the endochondral bone and the membranous bone...
2016: Acta Neurochirurgica. Supplement
Junichi Miyamoto, Kyo Niijima
An intracranial dural arteriovenous fistula(dAVF)was incidentally detected in a 39-year-old man during a medical checkup. Except for a mild episode of pneumonia at the age of 22 years, his medical history was unremarkable. He had no family history of hereditary hemorrhagic telangiectasia(HHT). The dAVF was treated radically via ligation of the fistula, without any complications. Postoperative angiography demonstrated that the dAVF had completely healed, but showed an aberrant, dilatated, and tortuous internal mammary artery...
September 2016: No Shinkei Geka. Neurological Surgery
Syrone Liu, Dane C Lee, Tad Tanoura
The medial tentorial artery arises from the meningohypophyseal trunk, a branch of the cavernous internal carotid artery, and it is poorly visualized on angiography in the absence of pathologically increased blood flow. We present the case of a 38-year-old man with intraventricular hemorrhage from a tentorial dural arteriovenous fistula (DAVF) singularly supplied by a robust medial tentorial artery. Tentorial DAVFs comprise a rare but high-risk subset of DAVFs. The diagnosis was suggested by computed tomography and magnetic resonance imaging findings and confirmed with digital subtraction angiography...
September 2016: Radiology case reports
Bradley A Gross, Felipe C Albuquerque, Karam Moon, Cameron G McDougall
OBJECTIVE Many small series and technical reports chronicle the evolution of endovascular techniques for cranial dural arteriovenous fistulas (dAVFs) over the past 3 decades, but reports of large patient series are lacking. The authors provide a thorough analysis of clinical and angiographic outcomes across a large patient cohort. METHODS The authors reviewed their endovascular database from January 1996 to September 2015 to identify patients harboring cranial dAVFs who were treated initially with endovascular approaches...
September 2, 2016: Journal of Neurosurgery
Susumu Yamaguchi, Nobutaka Horie, Kentaro Hayashi, Shuji Fukuda, Yoichi Morofuji, Takeshi Hiu, Tsuyoshi Izumo, Minoru Morikawa, Takayuki Matsuo
BACKGROUND: Parent artery occlusion for intractable aneurysms or sinus packing for dural arteriovenous fistulas (DAVFs) is sometimes difficult and requires many expensive coils to accomplish complete occlusion. To help solve these problems, we reviewed our experience using 0.035-inch coil (0.035 coil; Boston Scientific, San Leandro, CA, USA), which has been used in cardiovascular and abdominal lesions. METHODS: These 0.035 coils were preferably used in addition to the detachable and fibered coils for patients with intractable aneurysms, traumatic vessel blowout, and DAVF...
November 2016: Acta Neurochirurgica
Bradley A Gross, Felipe C Albuquerque, Karam Moon, Cameron G McDougall
BACKGROUND: With the introduction of Onyx, transarterial embolization has become the most common endovascular approach to treating dural arteriovenous fistulas (dAVFs), often via the middle meningeal or occipital arteries. The ascending pharyngeal artery (APA) is a less frequently explored transarterial route because of its small caliber, potential anastomoses to the internal carotid and vertebral arteries, and vital supply to lower cranial nerves. OBJECTIVE: To review our institutional experience and highlight the prevalence of APA supply to dAVFs and cases where it is a safe and effective pedicle for embolization...
August 31, 2016: Journal of Neurointerventional Surgery
Jayaprakash Harsha Kamble, Krishnan Parameswaran
Subcortical T2 hypointensity is an uncommon finding seen in very limited conditions such as multiple sclerosis, Sturge-Weber syndrome, and meningitis. Some of the conditions such as moyamoya disease, severe ischemic-anoxic insults, early cortical ischemia, and infarcts are of "arterial origin." We describe two conditions in which "venous congestion" plays a major role in T2 hypointensity - cerebral venous sinus thrombosis (CVST) and dural arteriovenous fistula (dAVF). The third case is a case of meningitis, showing T2 hypointensity as well, and can be explained by the "venous congestion" hypothesis...
July 2016: Annals of Indian Academy of Neurology
Satoru Tanioka, Yu Sato, Mai Nampei, Kazuhiko Tsuda, Shigehiko Niwa, Hidenori Suzuki
BACKGROUND: Cavernous sinus (CS) dural arteriovenous fistula (DAVF) rarely causes intracranial hemorrhage. The authors describe a case of CS DAVF presenting with intracranial hemorrhage, focusing on the findings in digital subtraction angiography (DSA) performed before and after the onset. CASE DESCRIPTION: An 80-year-old woman, diagnosed as Borden type 3 CS DAVF on DSA 2 years before, presented with subarachnoid hemorrhage and right temporal subcortical hemorrhage...
August 24, 2016: World Neurosurgery
Farhan A Mirza, Justin F Fraser
CASE: A 24-year-old woman presented with headache, nausea, and vomiting, and was found to have chronic superior sagittal sinus (SSS) thrombosis and multiple dural arteriovenous fistulae (dAVFs). Despite anticoagulant therapy and successful recanalization of her sinus, her fistulae persisted, and she developed additional separate pial arteriovenous fistulae (pAVFs). Her fistulae were treated with staged endovascular embolization, open clipping, and gamma knife radiosurgery over the course of 10 months...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Steven W Hetts, Parham Moftakhar, Neil Maluste, Heather J Fullerton, Daniel L Cooke, Matthew R Amans, Christopher F Dowd, Randall T Higashida, Van V Halbach
OBJECTIVE Intracranial dural arteriovenous fistulas (DAVFs) are rare in children. This study sought to better characterize DAVF presentation, angioarchitecture, and treatment outcomes. METHODS Children with intracranial DAVFs between 1986 and 2013 were retrospectively identified from the neurointerventional database at the authors' institution. Demographics, clinical presentation, lesion angioarchitecture, treatment approaches, angiographic outcomes, and clinical outcomes were assessed. RESULTS DAVFs constituted 5...
August 19, 2016: Journal of Neurosurgery. Pediatrics
Collin M Torok, Raul G Nogueira, Albert J Yoo, Thabele M Leslie-Mazwi, Joshua A Hirsch, Christopher J Stapleton, Aman B Patel, James D Rabinov
PURPOSE: The purpose of this article is to present a case series of transarterial venous sinus occlusion for dural arteriovenous fistulas (DAVFs) of the transverse and sigmoid sinuses. MATERIALS AND METHODS: From 2006 to 2012, 11 patients with DAVF of the transverse and sigmoid sinuses were treated with transarterial closure of the affected venous sinus using ethylene vinyl alcohol copolymer (ONYX). The consecutive retrospective cohort included six female and five male patients with an age range of 30-79...
August 16, 2016: Interventional Neuroradiology
Frédéric Clarençon, Federico Di Maria, Joseph Gabrieli, Alexandre Carpentier, Silvia Pistochi, Bruno Bartolini, Chiheb Zeghal, Jacques Chiras, Nader-Antoine Sourour
Transverse-sigmoid dural arteriovenous fistulas (TS DAVFs) can be challenging to treat by endovascular means. Indeed, a total cure of the fistula can only be achieved when complete occlusion of the fistulous point(s) is obtained by penetration of the embolic agent. However, in some cases, especially for transosseous branches from extracranial arteries like the occipital artery (OcA) or the superficial temporal artery (STA), such penetration is usually poor, leading to major proximal reflux and incomplete fistula obliteration...
October 2016: Acta Neurochirurgica
Felipe Padovani Trivelato, Luciano Bambini Manzato, Paulo Moacir Mesquita Filho, Alexandre Cordeiro Ulhôa, José Ricardo Vanzin, Daniel Giansante Abud, Marco Túlio Salles Rezende
INTRODUCTION: The authors present a retrospective series of their clinical experience in the treatment of cavernous dural arteriovenous fistulas (DAVF) by direct transorbital puncture of the cavernous sinus as an alternative to the endovascular approach. METHODS: Between October 2012 and September 2014, eight patients harboring cavernous DAVF underwent percutaneous treatment by direct transorbital puncture of the cavernous sinus at three institutions. All patients presented with ocular symptoms...
August 9, 2016: Clinical Neuroradiology
Stephanie Lescher, Sonja Gehrisch, Sigrun Klein, Joachim Berkefeld
PURPOSE: The purpose of this pilot study was to demonstrate the applicability of time-resolved three-dimensional (3D) reconstructions from 3D digital subtraction angiography (DSA) rotational angiography (RA) datasets (four-dimensional (4D) DSA) to provide a more detailed display of the architecture of intracranial vascular malformations. METHODS: The experimental reconstruction software was applied to the existing 3D DSA datasets obtained with Siemens Artis zee biplane neuroangiography equipment...
August 4, 2016: Journal of Neurointerventional Surgery
Matthew David Alexander, Van Halbach, Andrew Nicholson, Fabio Settecase, Robert J Darflinger, Matthew R Amans
Dural arteriovenous fistulas (DAVFs) can be complex lesions that require a well trained eye for proper characterization and management decisions. With numerous possible arteries to supply and veins to drain them, DAVFs are often complex lesions. To best treat these complex lesions, the neurointerventionalist should be adept at treating them with multiple techniques. This report describes a unique case in which a DAVF was treated with arterial sclerotherapy using ethanol from a transvenous approach.
July 20, 2016: Journal of Neurointerventional Surgery
Won Young Kim, Jin Bum Kim, Taek Kyun Nam, Young Baeg Kim, Seung Won Park
Intracranial dural arteriovenous fistula (dAVF) usually results in various problems in the brain. But it can be presented as a myelopathy, which may make early diagnosis and management to be difficult. We recently experienced a case of cervical myelopathy caused by intracranial dAVF. A 60-year-old man presented with a 3-year history of gait disturbance due to a progressive weakness of both legs. Neurological examination revealed spastic paraparesis (grade IV) and Babinski sign on both sides. Magnetic resonance imaging showed serpentine vascular signal voids at C2-T1 on T2-weighted image with increased signal intensity and swelling of spinal cord at C1-C4...
June 2016: Korean Journal of Spine
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