scholarly journals A Case of Spontaneous Acute Subdural Hemorrhage Caused by a Dural Arteriovenous Fistula on the Convexity without Cortical Venous Reflux

2019 ◽  
Vol 11 (3) ◽  
pp. 312-318 ◽  
Author(s):  
Keita Yamauchi ◽  
Shunsuke Takenaka ◽  
Tomohiro Iida ◽  
Hideki Sakai
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Middle Meningeal Artery ◽  
Neurological Deficits ◽  
Acute Subdural Hematoma ◽  
Subdural Hemorrhage ◽  
Venous Reflux ◽  
Sagittal Sinus ◽  
Cortical Venous Reflux

Bleeding from a dural arteriovenous fistula (DAVF) typically occurs in the form of an intracerebral or subarachnoid hemorrhage. Here, we report a rare case of a DAVF with an acute subdural hematoma (ASDH). A 29-year-old male presented to the emergency department with a complaint of progressing headache and nausea, with no reported episode of head trauma. Non-contrast CT revealed a left ASDH with a moderate midline shift. Digital subtraction angiography revealed a DAVF on the left parietal convexity. The DAVF was fed by the middle meningeal artery and drained into the superior sagittal sinus and the sphenoparietal sinus via the diploic vein without cortical venous reflux. The DAVF was treated with transarterial embolization using 25% diluted n-butyl cyanoacrylate prior to hematoma removal. The bleeding point was confirmed on the inner surface of the dura mater. The patient recovered well without any neurological deficits.

A case of dural arteriovenous fistula draining to the diploic vein presenting with intracerebral hemorrhage

2016 ◽  
Vol 124 (3) ◽  
pp. 726-729 ◽  
Author(s):  
Rie Yako ◽  
Osamu Masuo ◽  
Kenji Kubo ◽  
Yasuhiko Nishimura ◽  
Naoyuki Nakao
Keyword(s):  
Intracerebral Hemorrhage ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Unusual Case ◽  
Transarterial Embolization ◽  
Ct Scanning ◽  
Middle Meningeal Artery ◽  
Disturbance Of Consciousness ◽  
Cortical Venous Reflux ◽  
The Right

The authors report an unusual case of a dural arteriovenous fistula (dAVF) draining only to the diploic vein and causing intracerebral hemorrhage. A 62-year-old woman presented with disturbance of consciousness and left hemiparesis. Brain CT scanning on admission showed a right frontal subcortical hemorrhage. Digital subtraction angiography revealed an arteriovenous shunt located in the region around the pterion, which connected the frontal branch of the right middle meningeal artery with the anterior temporal diploic vein and drained into cortical veins in a retrograde manner through the falcine vein. The dAVF was successfully obliterated by percutaneous transarterial embolization with N-butyl-2-cyanoacrylate. The mechanism of retrograde cortical venous reflux causing intracerebral hemorrhage is discussed.

scholarly journals A hemorrhagic complication after Onyx embolization of a tentorial dural arteriovenous fistula: A caution about subdural extension with pial arterial supply

2017 ◽  
Vol 23 (3) ◽  
pp. 307-312 ◽  
Author(s):  
Kenichi Sato ◽  
Yasushi Matsumoto ◽  
Hidenori Endo ◽  
Teiji Tominaga
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Proximal Part ◽  
Middle Meningeal Artery ◽  
Arterial Supply ◽  
Acute Subdural Hematoma ◽  
Hemorrhagic Complication ◽  
Subdural Space ◽  
Arterial Bleeding

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. Emergency craniotomy revealed continuous arterial bleeding from a viable glomus-like vascular structure around the proximal part of the embolized draining vein, fed by a pial artery arising from the posterior cerebral artery. Pathologic findings suggested diagnosis of vascular malformation extending into the subdural space. Tentorial DAVFs can extend to the subdural space along their drainage route, and may be involved in severe hemorrhagic complications of curative endovascular treatment using Onyx, particularly those with pial arterial supply.

scholarly journals Left temporal craniotomy and direct microcatheterization of the middle meningeal artery for treatment of a complex temporal dural arteriovenous fistula

2019 ◽  
Vol 46 (Suppl_2) ◽  
pp. V8
Author(s):  
Daniel M. S. Raper ◽  
Nasser Mohammed ◽  
M. Yashar S. Kalani ◽  
Min S. Park
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Treatment Approach ◽  
Transarterial Embolization ◽  
Middle Meningeal Artery ◽  
Intraoperative Angiography ◽  
Arteriovenous Fistulae ◽  
Posterior Division ◽  
Technical Considerations ◽  
Meningeal Artery

The preferred method for treating complex dural arteriovenous fistulae of the transverse and sigmoid sinuses is via endovascular, transarterial embolization using liquid embolysate. However, this treatment approach mandates access to distal dural feeding arteries that can be technically challenging by standard endovascular approaches. This video describes a left temporal craniotomy for direct stick microcatheterization of an endovascularly inaccessible distal posterior division of the middle meningeal artery for embolization of a complex left temporal dural arteriovenous fistula. The case was performed in the hybrid operative suite with biplane intraoperative angiography. Technical considerations, operative nuances, and outcomes are reviewed.The video can be found here: https://youtu.be/Dnd4yHgaKcQ.

“Loop-like formation” in the cortical venous reflux of dural arteriovenous fistula with intracranial hemorrhage

2014 ◽  
Vol 41 (5) ◽  
pp. 316-321 ◽  
Author(s):  
Masaomi Koyanagi ◽  
Nobuyuki Sakai ◽  
Hidemitsu Adachi ◽  
Yasushi Ueno ◽  
Takeharu Kunieda ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Intracranial Hemorrhage ◽  
Dural Arteriovenous Fistula ◽  
Venous Reflux ◽  
Cortical Venous Reflux

Abstract T P368: Subcortical Calcification on CT as Diagnostic Sign of Transverse-Sigmoid Dural Arteriovenous Fistula With Cortical Venous Reflux

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Shunji Mugikura ◽  
Takahiro Metoki ◽  
Takaki Murata ◽  
Noriko Kurihara ◽  
Yasushi Matsumoto ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Posterior Part ◽  
Ct Scans ◽  
Venous Reflux ◽  
Specific Symptom ◽  
Diagnostic Sign ◽  
Cortical Venous Reflux ◽  
Diagnostic Symptoms

Background: and purpose The annual mortality rate of the patients who had dural arteriovenous fistula (dAVF) with cortical venous reflux (CVR) is high without treatment and early diagnosis is considered desirable. However, diagnostic symptoms of dAVF with CVR are varied and sometimes non specific or chronic one such as tinnitus, headache, dizziness, dementia and so on, which causes of delay in diagnosis. We sought to determine the subcortical calcifications on computed tomography (CT) scans as the diagnostic sign of dAVF with CVR. Material and methods: In 119 consecutive patients diagnosed with dAVF by the cerebral angiographic findings, we reviewed for the prevalence of subcortical calcifications on CT, shunting sites and side of shunting and the presence of cortical venous reflux (CVR) on angiograms and clinical symptoms leading to the diagnosis (diagnostic symptoms). Results: Subcortical calcifications on CT scans were seen in 10 patients (8.4% of 119 patients with dAVF). All of them had dAVF of transverse-sigmoid sinus (TS-dAVF) with CVR. Prevalence of subcortical calcifications was significantly higher in patients with TS-dAVF (P<0.001) (21%, 10 of 48 patients) than in patients with other than TS-dAVF (0 of 71 patients), and significantly higher in patients with CVR (P<0.001) (19 %, 10 of 52 patients) than in patients without CVR (0%, 0 of 67 patients). Subcortical calcifications tended to limited in the posterior part of the same hemisphere as hemisphere with shunting and appeared to be curvilinear ones predominantly involving the cortico-medullary junction at the bottom of cerebral gyri. Prevalence of subcortical calcifications was significantly higher in patients with chronic or non specific symptom (P<0.001, 26 %, 8 of 31 patients) than those with acute or ophthalmic symptom (2%, 2 of 88 patients). Conclusion: Subcortical calcification on CT is a sign of TS-dAVF with CVR, specifically in patients who present chronic or non specific symptoms. Subcortical calcifications found in TS-dAVF could be caused by venous congestion due to long-lasting CVR without being noticed or diagnosed.

AGGRESSIVE INTRACRANIAL DURAL ARTERIOVENOUS FISTULA PRESENTING WITH CEREBROSPINAL FLUID RHINORRHEA

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. E1208-E1209 ◽  
Author(s):  
Peter W.A. Willems ◽  
Robert A Willinsky ◽  
Yoram Segev ◽  
Ronit Agid
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Cerebrospinal Fluid Leak ◽  
Minor Trauma ◽  
Venous Reflux ◽  
Increased Intracranial Pressure ◽  
Cortical Venous Reflux ◽  
Fluid Leak

Abstract OBJECTIVE This is the first report of an aggressive dural arteriovenous fistula presenting with rhinorrhea. It demonstrates the importance of recognizing increased intracranial pressure, and its underlying cause, as the predisposing factor to a spontaneous cerebrospinal fluid leak because this carries implications for management. CLINICAL PRESENTATION Ten years after minor trauma and directly after an intercontinental flight, a 43-year-old woman presented with rhinorrhea. Right-sided pulsatile tinnitus had been present for the past 9 years. Imaging demonstrated an intracranial dural arteriovenous fistula of the right transverse sinus with cortical venous reflux. Magnetic resonance imaging findings indicated long-standing increased intracranial pressure. INTERVENTION The fistula was treated by endovascular means, using both transvenous and transarterial approaches, which led to immediate relief of the tinnitus and resolution of the rhinorrhea within 4 days. CONCLUSION A dural arteriovenous fistula should be included in the differential diagnosis of underlying causes of increased intracranial pressure when examining a patient with a cerebrospinal fluid leak. Treatment of the fistula should precede attempts to treat the rhinorrhea, especially if the fistula has cortical venous reflux.

scholarly journals Endovascular Treatment of a Dural Arteriovenous Fistula of the Transverse Sinus by Recanalisation, Angioplasty and Stent Deployment

2003 ◽  
Vol 9 (1) ◽  
pp. 65-69 ◽  
Author(s):  
W. Weber ◽  
B. Kis ◽  
J. Esser ◽  
P. Berlit ◽  
D. Kühne
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Venous Drainage ◽  
Venous Hypertension ◽  
Venous Reflux ◽  
Stent Deployment ◽  
Total Occlusion ◽  
Cortical Venous Reflux

We report the endovascular treatment of a 40-year-old woman with bilaterally thrombosed transverse sinuses and a dural arteriovenous fistula (DAVF) causing cortical venous reflux by recanalization, angioplasty and stent deployment of the occluded sinus segment followed by occlusion of the DAVF by stent deployment in the fistulous segment. By recanalization of the occluded sinus we re-established normal anterograde venous drainage and eliminated the venous hypertension and cortical venous reflux. After the procedure, the patient was treated with aspirin and clopidogrel for three months. A follow-up examination showed total occlusion of the DAVF, patency of the sinus and a complete resolution of the clinical symptoms.

Diagnostic accuracy of CTA and MRI/MRA in the evaluation of the cortical venous reflux in the intracranial dural arteriovenous fistula DAVF

2017 ◽  
Vol 60 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Yen-Heng Lin ◽  
Yu-Fen Wang ◽  
Hon-Man Liu ◽  
Chung-Wei Lee ◽  
Ya-Fang Chen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Reflux ◽  
Cortical Venous Reflux
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