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Dura AV

Joyce Antony, Craig Hacking, Rosalind L Jeffree
Pachymeningeal enhancement, synonymous with dural enhancement, is a radiological feature best appreciated on a contrast-enhanced magnetic resonance imaging (MRI). The vasculature of the dura mater is permeable, facilitating avid uptake of contrast agent and subsequent enhancement. Thin, discontinuous enhancement can be normal, seen in half the normal population. In patients complaining of postural headaches worse on sitting, gadolinium-enhanced MRI findings of diffuse pachymeningeal enhancement is highly suggestive of benign intracranial hypotension...
October 2015: Neurosurgical Review
Keisuke Takai, Takashi Komori, Makoto Taniguchi
OBJECT The microvascular anatomy of spinal dural arteriovenous fistulas (AVFs), especially the relationships of the vessels with the dura mater, has yet to be angiographically demonstrated in detail and proven histologically. METHODS From January 2012 through April 2014, a total of 7 patients with spinal dural AVFs in the thoracic region underwent open microsurgical obliteration at Tokyo Metropolitan Neurological Hospital. The microvascular anatomy of spinal dural AVFs was comprehensively assessed by using advanced microangiography, including 3D computer graphics and intraoperative indocyanine green video angiography, and by histological findings...
October 2015: Journal of Neurosurgery. Spine
Anderson Chun On Tsang, Philip Yat Hang Tse, Grace Hoi Ting Ng, Gilberto Ka Kit Leung
BACKGROUND: Open surgical ligation is an effective treatment of spinal dural arteriovenous fistula (SDAVF). Until recently, the procedure would require an open laminectomy, which may potentially cause significant postoperative pain, spinal deformity, and instability due to disruptions of the spinal mechanics. Development in minimal access spine surgery provides an alternative approach that can minimize bone and soft tissue trauma. CASE DESCRIPTION: We report two patients who presented with progressive paraparesis secondary to thoracolumbar SDAVF...
2015: Surgical Neurology International
Srinivasan Paramasivam, Yasunari Niimi, Dan Meila, Alejandro Berenstein
Dural arteriovenous fistulas (DAVF) associated with our series of patients with vein of Galen malformations (VOGM) are analyzed and discussed. We retrospectively analyzed 87 consecutive cases of VOGM treated between May 2002 and December 2011 and identified 26 patients with DAVF. We gathered information from the clinical case records, angiographic images, MRI on presentation and during follow-up. The findings were analyzed to aid discussion. Among 87 patients treated by multi-stage endovascular embolization, age range from newborn to 19 years, 26(30%) had DAVF...
December 2014: Interventional Neuroradiology
Chao-Bao Luo, Feng-Chi Chang, Michael Mu-Huo Teng
Intracranial dural arteriovenous fistulas (DAVFs) are abnormal arteriovenous communications within the dura locating near a major venous sinus and are supplied by pachymeningeal arteries. DAVFs represent 10-15% of all intracranial arteriovenous malformations. The natural history and clinical manifestations are determined by location of the DAVFs and their angioarchitecture. Aggressive DAVF is usually associated with leptomeningeal venous drains or reflux. It may present with hemorrhagic or nonhemorrhagic stroke...
December 2014: Journal of the Chinese Medical Association: JCMA
Chad A Tuchek, Aaron A Cohen-Gadol
Spinal dural arteriovenous fistula (dAVF) is an acquired abnormal arterial-to-venous connection within the spinal dura with a wide range of clinical presentations and natural history. Spinal dAVF occurs when a radicular artery makes a direct anomalous shunt with a radicular vein within the dura of the nerve root sleeve. Spinal dAVFs are the most common vascular malformation of the spine. The authors present a patient who presented with sudden temporary lower extremity weakness secondary to an L-1 spinal dAVF...
September 2014: Neurosurgical Focus
Shinya Kohyama, Yoshiaki Kakehi, Fumitaka Yamane, Hidetoshi Ooigawa, Hiroki Kurita, Shoichiro Ishihara
Nontraumatic acute subdural hemorrhage (SDH) with intracerebral hemorrhage (ICH) is rare and is usually caused by severe bleeding from aneurysms or arteriovenous fistulas. We encountered a very rare case of spontaneous bleeding from the middle meningeal artery (MMA), which caused hemorrhage in the temporal lobe and subdural space 2 weeks after coil embolization of an ipsilateral, unruptured internal cerebral artery aneurysm in the cavernous portion. At onset, the distribution of hematoma on a computed tomography scan led us to believe that the treated intracavernous aneurysm could bleed into the intradural space...
October 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Hamid Borghei-Razavi, Werner Weber, Khairi-Mohamed Daabak, Uta Schick
UNLABELLED: We report a case of dural Arteriovenous Fistula (AVF) supplied by the lateral sacral artery that is located in the sacral region and presented as isolated thoracic myelopathy. METHOD AND RESULTS: After S3 hemilaminectomy and opening the dura, the engorged arterialized vein has been interrupted. Postoperatively, the patient's symptoms and myelopathy gradually resolved. CONCLUSION: We are going to highlight the clinical and surgical importance of our case and discuss the pathophysiology of such an unusual clinical finding...
September 2014: Clinical Neurology and Neurosurgery
Xianli Lv, Zhongxue Wu, Youxiang Li
The trigemino-cardiac reflex during Onyx embolization for dural arteriovenous fistula may be caused by mechanical or chemical stimulus to the terminals of the unencapsulated Ruffini-like receptors stemming from A-axons in the dural connective tissue at sites of dural arteries and sinuses. Slow A (Aδ) and fast A (Aβ) neurons may play a role in the stimulus afferent pathway due to their higher mechanosensitivity and chemosensitivity. These afferent pathway nerves are cholinergic innervations of the dura mater, which also contains vasoactive neuropeptides such as calcitonin gene-related peptide, substance P, and neurokinin A...
June 2014: Neuroradiology Journal
Shaun P Appaduray, James A J King, Alison Wray, Patrick Lo, Wirginia Maixner
Pediatric dural arteriovenous malformations (dAVMs) are rare lesions that have a high mortality rate and require complex management. The authors report 3 cases of pediatric dAVMs that presented with macrocrania and extracranial venous distension. Dural sinus thrombosis developed in 2 of the cases prior to any intervention, which is an unusual occurrence for this particular disease. All 3 cases were treated using staged endovascular embolization with a favorable outcome in 1 case and a poor outcome in the other 2 cases...
July 2014: Journal of Neurosurgery. Pediatrics
Qiang Li, Qi Zhang, Qing-Hai Huang, Yi-Bin Fang, Zhao-Long Zhang, Yi Xu, Jian-Min Liu
Dural arteriovenous fistulas (DAVFs) are associated with venous hypertension. Numerous studies have revealed high expression levels of vascular endothelial growth factor (VEGF) in human DAVF specimens, as well as in animal models of experimental venous hypertension. The objective of the present study was to clarify whether the VEGF signaling pathway is important in the development of DAVFs. Rats (n=216) were randomly divided into six groups. In the rats from five groups (groups A and C-E, n=45 in each group; group B, n=12), experimental venous hypertension was induced by right common carotid artery (CCA)‑external jugular vein (EJV) anastomosis, superior sinus occlusion and left transver sinus occlusion, while the remaining group (group F, n=24) underwent sham surgery...
May 2014: Molecular Medicine Reports
C Capel, J Peltier, M Lefranc, C Desenclos, C Chivot, H Deramond, D Le Gars
We report the case of a 49 year-old woman, who presented with an intracranial haemorrhage. During cerebral angiography investigations, we observed an unusual vertebral artery that originated from the external carotid artery and an uncommon origin of the occipital artery from the vertebral artery feeding a dural arteriovenous fistula grade IV. This rare vertebral artery origin is probably the remnant of a type II proatlantal artery. In addition, the origin of the occipital artery evoked a vascular development disease including a dural arteriovenous fistula which may be the result...
December 2013: Neuro-Chirurgie
Kiyoshi Onda, Yuichi Yoshida, Kounosuke Watanabe, Hiroyuki Arai, Hideo Okada, Tomoaki Terada
OBJECT: The authors previously reported a case of complex arteriovenous fistula (AVF) at C-1 with multiple dural and spinal feeders that were linked with a common medullary venous channel. The purpose of the present study was to collect similar cases and analyze their angioarchitecture to gain a better understanding of this malformation. METHODS: Three such cases, affecting 2 males and 1 female in their 60s who had presented with hematomyelia (2) or progressive myelopathy (1), were treated surgically, and the operative findings from all 3 cases were compared using digital subtraction angiography (DSA) to determine the angioarchitecture...
March 2014: Journal of Neurosurgery. Spine
Ayumi Narisawa, Toshiki Endo, Kenichi Sato, Mika Watanabe, Akira Takahashi, Teiji Tominaga
The authors report on a 49-year-old man with a thoracic spinal dural arteriovenous shunt (dAVS) in which rupture of a varix caused intramedullary hemorrhage. In the literature, patients with a thoracic dAVS predominantly present with congestive myelopathy; however, the patient featured in this report presented without increased deep tendon reflexes or muscle weakness, but instead with intermittent stabbing chest pain and paresthesia. Magnetic resonance images and angiograms demonstrated tortuous enlargement and the formation of a varix-like structure of the draining veins, features compatible with those of high-flow angiopathy...
March 2014: Journal of Neurosurgery. Spine
Patrick P Youssef, Albert Jess Schuette, C Michael Cawley, Daniel L Barrow
Dural arteriovenous fistulas are abnormal connections of dural arteries to dural veins or venous sinuses originating from within the dural leaflets. They are usually located near or within the wall of a dural venous sinus that is frequently obstructed or stenosed. The dural fistula sac is contained within the dural leaflets, and drainage can be via a dural sinus or retrograde through cortical veins (leptomeningeal drainage). Dural arteriovenous fistulas can occur at any dural sinus but are found most frequently at the cavernous or transverse sinus...
February 2014: Neurosurgery
Mikinobu Takeuchi, Aichi Niwa, Naoki Matsuo, Masahiro Joko, Takahiro Nakura, Masahiro Aoyama, Toyoharu Yokoi, Masakazu Takayasu
BACKGROUND CONTEXT: The clinical morphology of a filum terminale arteriovenous fistula (f-AVF) is well known; however, pathological details of the fistulized portion are unknown. Herein, we report the pathological findings of the f-AVF. STUDY DESIGN: Case report and literature review. PURPOSE: To present a detailed pathological examination of the fistulized portion of the f-AVF. METHODS: A 71-year-old man presented with gradually worsening bilateral foot paresthesias and anal dysesthesia...
February 1, 2014: Spine Journal: Official Journal of the North American Spine Society
Xiaojian Lu, Xuanfeng Qin, Lanchun Ni, Jian Chen, Feng Xu
Tentorial dural arteriovenous fistula (DAVF) as a cause of trigeminal neuralgia is extremely rare. Although less than 10 cases have been reported in the literature, all cases presented with ipsilateral trigeminal neuralgia. Here we report a unique case of tentorial DAVF manifesting as contralateral trigeminal neuralgia. A 58-year-old man presented with right-sided trigeminal neuralgia. Cerebral angiography revealed a left tentorial DAVF and the MR imaging demonstrated a variceal venous dilatation occupying the left lateral pontine cistern and multiple venous flow voids adjacent to the right trigeminal nerve root entry zone...
2013: BMJ Case Reports
V Gilard, S Curey, E Tollard, F Proust
We report the case of a 59-year-old woman admitted for a sudden headache due to a subarachnoid haemorrhage. On CT scan, the clots predominated into the posterior fossa without high-density in the sylvian or interhemispheric fissures. The vertebral angiography revealed a dural arteriovenous fistula at the foramen magnum associated to an aneurysm of the cervical anterior spinal artery. Due to the high rebleeding risk of a dural shunt, we proposed curative treatment using microsurgical interruption of the intradural draining vein...
December 2013: Neuro-Chirurgie
R Rispoli, R Mastrostefano, G Passalacqua, P Filauri, M Fontana
Spinal dural arteriovenous fistulae are the most common type of spinal vascular malformations (AVMs). They have been classified into four types: dural AVM (type I), glomus AVM (type II), juvenile AVM (type III), and intradural direct arteriovenous fistula (type IV). Intradural AVMs manifest as subarachnoid or intramedullary hemorrhages, whereas dural AVM manifest as epidural hematoma. Spinal osseous epidural arteriovenous fistula (AVF) is not a well-defined vascular abnormality in the spine and consists in a high-flow vascular lesion outside the dura or spinal canal...
August 29, 2009: Neuroradiology Journal
Benjamin Gory, Suzana Saleme, David Ayoub, Aymeric Rouchaud, Tomaz Seruga, Marie Paule Boncoeur Martel, Charbel Mounayer
BACKGROUND AND IMPORTANCE: The goal of spinal dural arteriovenous fistula (DAVF) treatment is to permanently occlude the proximal draining vein and the fistula itself, which can be achieved by open surgery or endovascular treatment. The endovascular approach is currently the primary treatment, but it requires the presence of an access as close to the site of the fistula as possible. This case illustrates that the retrocorporeal artery may be an alternative option in case of previous embolization failure with proximal occlusion of the radicular arteries...
December 2013: Neurosurgery
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