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Dural AV fistula

Yu-Han Chang, Chao-Bao Luo, Shuu-Jiun Wang, Shih-Pin Chen
Background Of the multiple etiologies identified for symptomatic cluster headache, vascular origin is common; however, there are no known reports of arteriovenous (AV) fistulas. Here we report a case with typical presentation of cluster headache, which might be associated with middle meningeal AV fistulas. Case report The subject is a 49-year-old man with a 7-year history of episodic left-side cluster headache, consistent with the criteria in the International Classification of Headache Disorders, 3rd edition, beta version (ICHD-3β)...
January 1, 2017: Cephalalgia: An International Journal of Headache
Sanjith Aaron, Anupriya Arthur, A T Prabakhar, Pavitra Mannam, N K Shyamkumar, Sunithi Mani, Vivek Mathew, Jeyanthi Peter, Ajith Sivadasan, Anika Alexander, M Karthik, Rohith Ninan Benjamin, Mathew Alexander
Visual impairment can complicate cerebral venous thrombosis (CVT). Here, we describe the various pathophysiological mechanisms and treatments available. A retrospective chart review of all patients treated for CVT in a large quaternary teaching hospital was done, and cases with visual impairment due to CVT were identified. The various mechanisms causing visual impairment in CVT were (1) raised intracranial pressure (ICP) caused by venous thrombosis without venous infarcts resulting in a benign intracranial hypertension-like presentation of CVT, (2) venous infarcts involving the occipital cortex, (3) raised ICP following the development of a secondary dural arteriovenous (AV) fistula, and (4) arterial occipital infarcts due to posterior cerebral artery compression secondary to herniation in large venous infarcts...
July 2017: Annals of Indian Academy of Neurology
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
Keisuke Takai
The purposes of this study were to review historical changes in the classification of spinal arteriovenous (AV) shunts and to propose a practical classification system. The associated literature regarding the classification of spinal AV shunts was reviewed in the angiography era between 1967 and 2015. The classification systems of spinal AV shunts and a proposed classification system were presented with neuroradiological imaging and medical illustrations. There have been seven major classification systems based on the evolution of diagnostic methods as well as treatments for spinal AV shunts: the first description of spinal AV shunts diagnosed and classified using spinal angiography in 1971; the second classification based on a case report of intradural direct perimedullary arteriovenous fistulas (AVFs) treated by microsurgery in 1987; the third classification based on a case series of intradural perimedullary AVFs treated by endovascular interventions in 1993; the fourth and fifth classification systems based on a case series of spinal AVFs and arteriovenous malformations (AVMs) treated by microsurgery or endovascular interventions in 2002; the sixth classification based on a case series of cranio-spinal dural AV shunts in 2009; and the seventh classification based on a case series of extradural AVFs treated by microsurgery and endovascular interventions in 2011...
July 15, 2017: Neurologia Medico-chirurgica
Thomas J Sorenson, Biagia La Pira, Joshua Hughes, Giuseppe Lanzino
BACKGROUND: Dural arteriovenous fistulas (DAVFs) of the craniocervical junction are uncommon vascular lesions, which often require surgical treatment even in the endovascular era. METHODS: Most commonly, the fistula is placed laterally, and surgical ligation is performed through a lateral suboccipital craniotomy. After dural opening, the area is inspected, and the arterialized vein is identified emerging from the dura, often adjacent to the entry point of the vertebral artery, and ligated...
August 2017: Acta Neurochirurgica
Yasunari Niimi
Intracranial arteriovenous shunts (ICAVS) in young children are characterized by frequent high-flow fistulas. In association with high-flow fistulas and the physiological condition of the developing brain and heart, each ICAVS type tends to present at a certain age with unique symptoms. Vein of Galen aneurysmal malformation (VGAM) and dural sinus malformation with arteriovenous (AV) shunt tend to present in the neonate with high output cardiac failure. In infancy, VGAM, pial arteriovenous fistula (AVF) and infantile dural AVF (DAVF) tend to present with hydrodynamic disorder such as macrocephaly, ventriculomegaly, prominent facial veins, and developmental delay...
March 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
Asaf Honig, Ruth Eliahou, Roni Eichel, Ari Aharon Shemesh, Tamir Ben-Hur, Eitan Auriel
Bilateral thalamic infarction (BTI) typically presents as a sleep-like coma (SLC) without localizing signs, posing a diagnostic challenge that may lead the treating physician to search for toxic or metabolic causes and delay treatment. We review our experience with BTI of different etiologies, and emphasize the critical role of timely imaging, diagnosis, and management in a series of 12 patients with a presentation of SLC and acute BTI who were managed in our Medical Centers from 2006-2015. In 11/12, urgent head CT scans showed normal brain tissue, while diffusion-weighted (DWI) MRI revealed symmetric bilateral thalamic hyperintense lesions with variable degrees of brainstem involvement...
December 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Mohamed Abdelsadg, Avinash Kumar Kanodia, Peter Keston, James Galea
We present a case of intracranial arteriovenous fistula with perimedullary venous drainage presenting with acute myelopathy, which is an unusual presentation of this uncommon condition. Subsequent catheter angiogram defined the arterial feeders from the meningohypophyseal trunk and petrosal branch of the middle meningeal artery. The patient was successfully embolised, resulting in complete obliteration of the fistula, and significant resolution of brainstem and cervical cord changes along with clinical improvement...
April 27, 2016: BMJ Case Reports
Masaki Komiyama, Aiko Terada, Tomoya Ishiguro
Neonatal neuro-intervention is challenging. The purpose of this article is to report the neuro-intervention for the neonates with brain arteriovenous fistulas (AVFs), with special reference to access routes. Fifteen neonates (12 boys and 3 girls) who underwent neuro-intervention within the first 14 days of life were -included. Their diagnoses included vein of Galen aneurysmal malformation (6), dural sinus malformations with arteriovenous (AV) shunts (6), pial AVF (2), and epidural AVF (1). Birth weight ranged from 1,538 g to 3,778 g (mean 2,525 g)...
2016: Neurologia Medico-chirurgica
Yosef Laviv, Ekkehard Kasper, Eliyahu Perlow
Galenic dural arteriovenous fistula (DAVF) represents a unique, hard to treat subgroup of tentorial DAVFs. We present an unusual case of hemorrhagic Galenic DAVF in a 54-year-old woman. The fistula drained directly to the vein of Galen through multiple feeders. Complete occlusion of the fistula was achieved through transarterial embolization. Deep venous drainage remained intact and the patient recovered well. To our knowledge, this is the first report on complete closure of hemorrhagic Galenic DAVF using transarterial embolization with complete obliteration of vein of Galen...
February 2016: Acta Neurochirurgica
Tatsuo Oshiro, Okitaka Nakayama, Chiaki Ohba, Yoko Ohashi, Junichi Kawakubo, Tomoaki Nagamine, Masaki Komiyama
PURPOSE: The purpose of this study was to report transumbilical arterial embolization of a large dural arteriovenous fistula (AVF) in a low-birth-weight neonate with congestive heart failure (CHF). CASE PRESENTATION: A female neonate was delivered by cesarean section at 31 weeks of gestation. Her birth weight was 1538 g and Apgar scores were 6 at both 1 and 5 min. Because of dyspnea and retracted respiration immediately after birth, she required mechanical ventilation...
April 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
I Wanke, D A Rüfenacht
Acquired arteriovenous malformations, such as is the case with dural arteriovenous fistulae (DAVF), are the consequence of a pathological new arterial ingrowth into venous spaces that reaches directly the venous lumen, without interposition of a capillary network, thereby creating an AV-shunt.The following concise text will provide elements in regards to diagnosis, indication for treatment discussion and choice of endovascular treatment (EVT) method.
October 2015: Clinical Neuroradiology
Thomas Robert, Raphaël Blanc, Gabriele Ciccio, Stanislas Smajda, Hocine Redjem, Robert Fahed, Michel Piotin
OBJECTIVE: Trigeminal neuralgia (TN) is a rare revealing symptom of dural or cerebral arteriovenous (AV) shunt. Few isolated cases have described the association between TN and arteriovenous shunt. We presented our experience concerning cerebral AV shunt revealed by a TN. METHODS: Between 2003 and 2013, 548 brain AV malformations (bAVM) and 268 dural AV fistulas (dAVF) were treated and a retrospective analysis identified 10 consecutive cases with TN. We reviewed their clinical and angiographic data and as well as their outcome after endovascular treatment...
November 2015: Clinical Neurology and Neurosurgery
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
Khaled M Krisht, Michael Karsy, Wilson Z Ray, Andrew T Dailey
Seven cases of adult spinal vascular malformations presenting in conjunction with spinal dysraphism have been reported in the literature. Two of these involved male patients with a combined dural arteriovenous fistula (DAVF) and lipomyelomeningocele. The authors present the third case of a patient with an extraspinal DAVF and associated lipomyelomeningocele in a lumbosacral location. A 58-year-old woman with rapid decline in bilateral motor function 10 years after a prior L4-5 laminectomy and cord detethering for diagnosed tethered cord underwent magnetic resonance imaging showing evidence of persistent cord tethering and a lipomyelomeningocele...
2015: Case Reports in Neurological Medicine
Alhafidz Hamdan, Rajeev Padmanabhan
BACKGROUND CONTEXT: Spinal dural arteriovenous fistulas (AVFs) are acquired lesions presenting typically with neurologic deficits secondary to chronic congestive myelopathy. The low-flow and low-volume nature of these lesions makes hemorrhage very unlikely, and intramedullary hemorrhage caused by thoracolumbar dural AVFs is exceedingly rare. PURPOSE: The purpose of this study was to report a case of intramedullary hemorrhage caused by a thoracolumbar dural AVF. STUDY DESIGN/SETTING: The study design included a case report and review of literature...
February 1, 2015: Spine Journal: Official Journal of the North American Spine Society
Severina Leu, Anton Valavanis, Gerasimos Baltsavias
Langer-Giedion syndrome (LGS) is a rare disease caused by deletion of chromosome 8q23.3-q24.11. Clinical manifestations include among others multiple exostoses, short stature, intellectual disability, and typical facial dysmorphism. Dural arterio-venous shunts (DAVS) in the pediatric age are rare lesions, which have been classified into three types: dural sinus malformations (DSM), infantile type DAVS (IDAVS), and adult type DAVS (ADAVS). We report a case of a patient with a known LGS who was diagnosed with complex intracranial dural AV fistula at the age of 20...
May 2015: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
J Marc C van Dijk, Astrid G W Korsten-Meijer, Aryan Mazuri
OBJECTIVES/HYPOTHESIS: A dural arteriovenous fistula (DAVF) with cortical venous reflux (CVR) is a dangerous neurovascular entity. A DAVF at the cribriform plate is typically silent until its inevitable presentation with intracranial hemorrhage. CASE SUMMARY: A 67-year-old male presented with severe epistaxis. Following unsuccessful conventional measures and a surgical exploration, a catheter angiography showed a DAVF at the cribriform plate, with its nidus extending into the nasal cavity...
November 2014: Laryngoscope
Gabriel Bioh, Richard Bogle
A 22 -year-old man presented with 6 months of sudden onset, incapacitating, left-sided chest pain occurring 1-2 times a week. The severity of the pain caused loss of consciousness several times leading to multiple fractures. Investigation with echocardiogram, exercise tolerance test, Holter monitor, chest X-ray and V/Q scan revealed no abnormality as did EEG and 48 h video telemetry. MRI of the thoracic and lumbar spine showed a spinal dural arteriovenous fistula (SDAVF) at the level of T6, confirmed on angiogram...
2014: BMJ Case Reports
M Delour Fam, Chris Scott, Alan Forster, Mahmoud H Kamel
BACKGROUND: Superior oblique myokymia (SOM) is a rare disorder in which the patient suffers episodic uniocular torsional eye movement associated with diplopia and oscillopsia . Although the pathophysiology has been narrowed down to erratic discharge of the trochlear nerve, yet the exact etiology remains unclear; a handful of cases have been described in association with an identifiable space occupying lesions or dural AV fistulae. Neurovascular compression theory has been postulated in the early 1980s and to our knowledge, very few reports exist in the literature accrediting this hypothesis in the pathogenesis of superior oblique myokymia...
August 2014: British Journal of Neurosurgery
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