Foramen Magnum Dural Arteriovenous Fistulas: Clinical Presentations and Treatment Outcomes, A Case-Series of 12 Patients

2017 ◽  
Vol 15 (3) ◽  
pp. 262-269 ◽  
Author(s):  
Mogwale S Motebejane ◽  
In Sup Choi
Keyword(s):  
Posterior Fossa ◽  
Intracranial Hemorrhage ◽  
Case Series ◽  
Foramen Magnum ◽  
Arteriovenous Fistulas ◽  
Progressive Myelopathy ◽  
Venous Sinuses ◽  
Clinical Presentations ◽  
Dural Arteriovenous Fistulas ◽  
Operative Notes

Abstract BACKGROUND Dural arteriovenous fistulas (DAVFs) are usually seen in relation to the venous sinuses, but in certain rare instances fistulas may not drain directly into the venous sinuses but rather drain into the cortical veins. This rare form of DAVF may present with either intracranial hemorrhage or myelopathy. The mode of clinical presentation is influenced by the venous outflow into either intracranial drainage or caudally intraspinal drainage. OBJECTIVE To evaluate the clinical presentations, angioarchitectural characteristics, and treatment of 12 patients who presented with DAVF in the region of the foramen magnum. METHODS In this case series we reviewed clinical charts, radiological images, and operative notes of 12 patients who were diagnosed of foramen magnum DAVF from December 1993 until April 2017. The angiographic studies were analyzed for feeding arteries, the location of the shunt, the venous drainage patterns, and the presence of venous side aneurysms. RESULTS Twelve patients were angiographically confirmed with foramen magnum DAVFs. They included 11 males and 1 female (M:F = 11:1). Mean age of 55.6 yr ranging between 42 yr and 71 yr of age. Eight patients presented with progressive myelopathy, 3 patients with posterior fossa intracranial hemorrhage, and 1 patient presented with lower cranial nerve IX and XII palsies due to mass effect. CONCLUSION A dural arteriovenous shunt, which may be located in the region of the foramen magnum, should be suspected in those cases of subarachnoid hemorrhage in the posterior fossa or progressive myelopathy mimicking spinal DAVF.

scholarly journals Intracranial hemorrhage from dural arteriovenous fistulas: clinical features and outcome

2013 ◽  
Vol 34 (5) ◽  
pp. E15 ◽  
Author(s):  
David J. Daniels ◽  
Ananth K. Vellimana ◽  
Gregory J. Zipfel ◽  
Giuseppe Lanzino
Keyword(s):  
Clinical Features ◽  
Intracranial Hemorrhage ◽  
Case Series ◽  
Venous Drainage ◽  
Sudden Onset ◽  
Residual Symptoms ◽  
Arteriovenous Fistulas ◽  
Common Location ◽  
Dural Arteriovenous Fistulas

Object In this paper the authors' goal was to review the clinical features and outcome of patients with intracranial dural arteriovenous fistulas (DAVFs) who presented with hemorrhage. Methods A retrospective study of 28 patients with DAVFs who presented with intracranial hemorrhage to 2 separate institutions was performed. The information reviewed included clinical presentation, location and size of hemorrhage, angiographic features, treatment, and clinical and radiologically documented outcomes. Clinical and radiological follow-up were available in 27 of 28 patients (mean follow-up 17 months). Results The vast majority of patients were male (86%), and the most common presenting symptom was sudden-onset headache. All DAVFs had cortical venous drainage, and about one-third were associated with a venous varix. The most common location was tentorial (75%). Treatment ranged from endovascular (71%), surgical (43%), Gamma Knife surgery (4%), or a combination of modalities. The majority of fistulas (75%) were completely obliterated, and most patients experienced excellent clinical outcome (71%, modified Rankin Scale score of 0 or 1). There were no complications in this series. Conclusions Case series, including the current one, suggest that the vast majority of patients who present with intracranial hemorrhage from a DAVF are male. The most common location for DAVFs presenting with hemorrhage is tentorial. Excellent outcomes are achieved with individualized treatment, which includes various therapeutic strategies alone or in combination. Despite the hemorrhagic presentation, almost two-thirds of patients experience a full recovery with no or minimal residual symptoms.

Beware of the Brain Stem:Craniocervical Dural Arteriovenous Fistulas. Case Series and Literature Review

Neurographics ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. 349-357
Author(s):  
M.A. McDonald ◽  
S.E. Olson ◽  
P. Abraham ◽  
J. Handwerker
Keyword(s):  
Literature Review ◽  
Mr Imaging ◽  
Case Series ◽  
Imaging Findings ◽  
Arteriovenous Fistulas ◽  
Timely Diagnosis ◽  
Clinical Presentations ◽  
Wide Range ◽  
Dural Arteriovenous Fistulas ◽  
The Brain

Craniocervical dural arteriovenous fistulas are rare but clinically important entities that are potentially treatable but often misdiagnosed given their wide range of clinical presentations and often nonspecific findings on CT and MR imaging. Although DSA remains the criterion standard for diagnosis, the present case series highlights imaging findings of craniocervical dural arteriovenous fistulas and potential mimics to aid the practicing radiologist in a timely diagnosis.

Artery of Davidoff and Schechter: A Large Angiographic Case Series of Dural AV Fistulas

2021 ◽  
pp. 194187442110222
Author(s):  
Neda Isabel Sedora Roman ◽  
Pavel Rodriguez ◽  
Hussein Nasser ◽  
Mougnyan Cox ◽  
Preethi Ramchand ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Posterior Cerebral Artery ◽  
Vascular Malformations ◽  
Surgical Techniques ◽  
Case Series ◽  
Arteriovenous Fistulas ◽  
Medical Centers ◽  
Dural Arteriovenous Fistulas ◽  
Av Fistulas ◽  
Angiographic Examination

The artery of Davidoff and Schechter (ADS) is the only meningeal branch of the posterior cerebral artery (PCA), supplying the medial tentorial margin and posterior portions of the falx. Given its small size, it is rarely identified on angiographic studies, unless enlarged in pathologies such as dural arteriovenous fistulas (DAVFs) or vascularized masses. This artery was first described by Wollschlaeger and Wollschlaeger in 1965, and to date, only a few reports have described its significance. The objective of this study is to report our experience with the ADS in dural fistulas from 2 tertiary medical centers and to emphasize the importance of recognizing this artery during angiographic examination of vascular tentorial and posterior fossa lesions. To our knowledge, this report demonstrates the largest angiographic case series published to date, recognizing a total of 7 patients with ADS arising secondary to a posterior fossa or tentorial DAVF and one of the largest reported series of DAVFs supplied by the ADS treated by endovascular and surgical techniques. Our cases validate the importance of prompt identification of the ADS for the diagnosis as well as endovascular treatment of vascular malformations in the posterior fossa and tentorial region.

Posterior Fossa Dural Arteriovenous Fistulas: Outcomes of endovascular treatment

2020 ◽  
Vol 47 (2) ◽  
pp. 79
Author(s):  
L. Détraz ◽  
K. Orlov ◽  
V. Berestov ◽  
V. Borodestky ◽  
A. Rouchaud ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Posterior Fossa ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas

scholarly journals Posterior Fossa Dural Arteriovenous Fistulas with Subarachnoid Venous Drainage: Outcomes of Endovascular Treatment

2019 ◽  
Vol 40 (8) ◽  
pp. 1363-1368 ◽  
Author(s):  
L. Détraz ◽  
K. Orlov ◽  
V. Berestov ◽  
V. Borodetsky ◽  
A. Rouchaud ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Posterior Fossa ◽  
Venous Drainage ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas

Progressive Gait Dysfunction

2016 ◽  
Author(s):  
Ji Y. Chong ◽  
Michael P. Lerario
Keyword(s):  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Endovascular Embolization ◽  
Arteriovenous Fistulas ◽  
Progressive Myelopathy ◽  
Spinal Vascular Malformations ◽  
Gait Dysfunction ◽  
Dural Arteriovenous Fistulas ◽  
Neurological Change ◽  
Spinal Arteriovenous Malformations

Spinal vascular malformations are rare, with dural arteriovenous fistulas (AVFs) accounting for the majority of the pathology. Unlike spinal arteriovenous malformations, which cause abrupt neurological change as a result of hemorrhage, spinal dural AVFs tend to result in a progressive myelopathy through venous congestion and cord edema. If diagnosed and treated early with endovascular embolization or microsurgery, some deficits may be reversible.

Dural arteriovenous fistulas presenting with brainstem dysfunction: diagnosis and surgical treatment

2012 ◽  
Vol 32 (5) ◽  
pp. E10 ◽  
Author(s):  
Charles Kulwin ◽  
Bradley N. Bohnstedt ◽  
John A. Scott ◽  
Aaron Cohen-Gadol
Keyword(s):  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Craniocervical Junction ◽  
Rare Entity ◽  
Arteriovenous Fistulas ◽  
Drainage Patterns ◽  
Clinical Presentations ◽  
Wide Range ◽  
Brainstem Dysfunction ◽  
Dural Arteriovenous Fistulas

A cerebral dural arteriovenous fistula (DAVF) is an acquired abnormal arterial-to-venous connection within the leaves of the intracranial dura with a wide range of clinical presentations and natural history. The Cognard classification correlates venous drainage patterns with neurological course, identifying 5 DAVF types with increasing rates of symptomatic presentation. A spinal DAVF occurs when a radicular artery makes a direct anomalous shunt with a radicular vein within the dural leaflets of the nerve root sleeve. A cervical DAVF is a rare entity, as most spinal DAVFs present as thoracolumbar lesions with myelopathy. In this paper the authors present 2 patients presenting initially with brainstem dysfunction rather than myelopathy secondary to craniocervical DAVF. The literature is then reviewed for similar rare aggressive DAVFs at the craniocervical junction presenting with brainstem symptomatology.

Long-term outcome in patients treated for benign dural arteriovenous fistulas of the posterior fossa

2010 ◽  
Vol 53 (7) ◽  
pp. 493-500 ◽  
Author(s):  
Andrea Bink ◽  
Joachim Berkefeld ◽  
Lubov Kraus ◽  
Christian Senft ◽  
Ulf Ziemann ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas
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