scholarly journals Spontaneous Subdural Hematoma and Behavioral Changes Due to a Dural Arteriovenous Fistula. A Case Report and Literature Review

2019 ◽  
Vol 9 (6) ◽  
pp. 63
Author(s):  
Zenaida Milagros Hernández-Díaz ◽  
Juan Carlos Llíbre-Guerra ◽  
Marianela Arteche-Prior ◽  
Tania de la Paz-Bermúdez ◽  
Angel Francisco Águila-Ruiz ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Behavioral Changes ◽  
Intracranial Arteriovenous Malformations ◽  
Behavioral Disturbances ◽  
Arteriovenous Fistulas ◽  
Diffuse White Matter ◽  
Dural Arteriovenous Fistulas ◽  
History Of ◽  
First Time ◽  
Venous Ischemia

Dural arteriovenous fistulas (DAVFs) represent 10–15% of intracranial arteriovenous malformations. Of these, only 12–29% cause intracranial hemorrhage. The presentation of DAVF as a subdural hematoma (SDH) and intraparenchymal hemorrhage (IPH) is infrequent; additionally, behavioral changes are not common among these patients. We report, for the first time in our country, the case of a 23-year-old man with no history of head injury, in which a brain computed tomography (CT) scan revealed SDH and IPH with behavioral disturbances. The angiotomography showed ecstatic venous vessels, indicating the presence of a DAVF, which was later confirmed by cerebral angiography. Endovascular therapy, which followed the clinical diagnosis, resulted in satisfactory evolution two years after treatment. A review of the literature concerning cases with DAVF and behavioral disturbances is presented. DAVF may lead to cognitive impairment, behavioral changes, and dementia as a result of diffuse white matter and thalamus modifications related to venous ischemia, and it should be considered as a reversible cause of vascular dementia.

Cerebral Venous Ischemia by Dural Arteriovenous Fistulas

2005 ◽  
Vol 14 (4) ◽  
pp. 152-156 ◽  
Author(s):  
Hiroyuki Nakase ◽  
Yasushi Shin ◽  
Kenta Fujimoto ◽  
Shoichiro Kawaguchi ◽  
Toshisuke Sakaki
Keyword(s):  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Venous Ischemia

scholarly journals Study of Dural Arteriovenous Fistula Drains into Leptomeningeal Vein without Sinus Interposition

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 127-134 ◽  
Author(s):  
T. Kawaguchi ◽  
M. Nakatani ◽  
T. Kawano
Keyword(s):  
Emergency Treatment ◽  
Superior Sagittal Sinus ◽  
Venous Drainage ◽  
Craniocervical Junction ◽  
Sigmoid Sinus ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Cranial Fossa ◽  
Venous Ischemia

We evaluated dural arteriovenous fistulas (DAVF) drains into leptomeningeal vein (LMV) without the venous sinus interposition. This type of DAVF contained the extra-sinusal type DAVF and the DAVF with so-called pure leptomeningeal venous drainage (PLMVD). We studied 15 patients with DAVF that flows into LMVD without passing into the sinus. The subjects were 5 patients with DAVF in the anterior cranial fossa, 2 with DAVF in the tentorium cerebelli, and 3 with DAVF in the craniocervical junction as extra-sinusal type DAVF and 3 with DAVF in the transverse sigmoid sinus and 2 with DAVF in the superior sagittal sinus as DAVF with PLMVD. This type appears to take a very aggressive course. The arterial pressure of the shunt is directly applied to LMV, which causes bending and winding of the vein, eventually varices, inducing intracranial haemorrhage or venous ischemia in the LMV reflux area. Emergency treatment should be performed as soon as possible. Although it is recognized that interruption of the draining vein is very effective, treatment methods such as TAE, direct surgery, and g knife treatment, or their combinations should be carefully chosen for each case.

Familial Intracranial Dural Arteriovenous Fistulas

Neurosurgery ◽  
2012 ◽  
Vol 72 (2) ◽  
pp. E310-E313 ◽  
Author(s):  
Josiah N. Orina ◽  
David J. Daniels ◽  
Giuseppe Lanzino
Keyword(s):  
Sinus Thrombosis ◽  
Prothrombin G20210a ◽  
Type I ◽  
Pulsatile Tinnitus ◽  
Laboratory Studies ◽  
Arteriovenous Fistulas ◽  
First Degree Relatives ◽  
G20210a Mutation ◽  
Dural Arteriovenous Fistulas ◽  
History Of

Abstract BACKGROUND AND IMPORTANCE: Intracranial dural arteriovenous fistulas (DAVFs) are acquired abnormal communications between dural arteries and veins. Risk factors for development include sinus thrombosis and hypercoagulability, such as occurs in heritable thrombophilias. While there have been reports of other types of vascular anomalies (such as cavernous and arteriovenous malformations) occurring in families, to our knowledge there have been no reports of familial intracranial DAVFs. We describe the first 2 cases of intracranial DAVFs occurring in first-degree relatives. CLINICAL PRESENTATION: A 66-year-old woman presented with an 18-month history of bilateral pulsatile tinnitus. Neurological examination was significant for a prominent pulsatile bruit over the left mastoid region. Laboratory studies demonstrated heterozygosity for Prothrombin G20210A mutation. Imaging disclosed a large left Type I Borden DAVF involving the distal transverse-sigmoid sinus junction. She underwent uncomplicated stereotactic radiosurgery to the fistula that led to complete resolution of her tinnitus and the fistula. A 73-year-old woman, the sister of the previous patient, presented with a 24-month history of pulsatile tinnitus affecting the left ear. Laboratory studies demonstrated heterozygosity for the Prothrombin G20210A mutation. Imaging revealed a left Type I Borden DAVF involving the left transverse and sigmoid sinuses. The patient's symptoms resolved spontaneously without treatment. Repeat imaging revealed interval involution of the fistula. CONCLUSION: We describe 2 sisters who were heterozygous for Prothrombin G20210A mutation and found to have DAVFs. Clinicians should be aware of the potential for these fistulas to congregate in first-degree relatives via heritable thrombophilias such as the Prothrombin G20210A mutation.

scholarly journals Post-partum Seizure from Subdural Hematoma Secondary to Cerebrospinal Fluid Leak Following Epidural Anesthesia

2019 ◽  
Vol 14 (3) ◽  
pp. 44-47
Author(s):  
Anna Whalen-Browne ◽  
Kristyne Onizuka ◽  
Maria Tiboni ◽  
Ragini Srinivasan
Keyword(s):  
Cerebrospinal Fluid ◽  
Epidural Anesthesia ◽  
Subdural Hematoma ◽  
Dural Puncture ◽  
Post Partum ◽  
Cerebrospinal Fluid Leak ◽  
Neurologic Sequelae ◽  
History Of ◽  
Fluid Leak ◽  
First Time

ABSTRACTHeadaches in the post-partum period are common, while new seizures are not. While many causes of post-partum headache are benign, it can be difficult to determine which patients warrant a more comprehensive workup to investigate for serious causes, which may only present later with neurologic sequelae such as new seizures. We suggest that persistent post-dural puncture headaches in the context of intrapartum epidural anesthesia can be suggestive of a serious cause such as intracranial hypotension or subdural hematoma. We describe a case of a 28-year-old G1P1 female presenting with a first-time seizure at 19 days post-partum caused by subdural hematoma from a persistent cerebrospinal fluid leak. This was in the context of a history of typical post-dural puncture headache following delivery. RÉSUMÉLes maux de tête dans la période post-partum sont fréquents, alors que les nouvelles crises ne le sont pas. Bien que de nombreuses causes de céphalées post-partum soient bénignes, il peut être difficile de déterminer quels patients justifient un bilan plus complet pour rechercher les causes graves, qui peuvent ne se présenter que plus tard avec des séquelles neurologiques comme de nouvelles crises. Nous suggérons que les maux de tête persistants post-ponctionnels dans le contexte de l’anesthésie épidurale intra-partum peuvent suggérer une cause grave comme l’hypotension intracrânienne ou un hématome sous-dural. Nous décrivons le cas d’une femme G1P1 de 28 ans qui présente une première crise d’épilepsie 19 jours après l’accouchement causée par un hématome sous-dural causé par une fuite persistante de liquide céphalorachidien. C’était dans le contexte d’une histoire de céphalées typiques après une ponction post-durale après l’accouchement.

scholarly journals Patients with cranial dural arteriovenous fistulas may benefit from expanded hypercoagulability and cancer screening

2018 ◽  
Vol 129 (4) ◽  
pp. 954-960 ◽  
Author(s):  
Sean P. Polster ◽  
Hussein A. Zeineddine ◽  
Joseph Baron ◽  
Seon-Kyu Lee ◽  
Issam A. Awad
Keyword(s):  
Clinical Management ◽  
Clinical Evidence ◽  
Clinical Care ◽  
Clinical Manifestations ◽  
Hypercoagulable State ◽  
Dural Sinus ◽  
Arteriovenous Fistulas ◽  
Imaging Results ◽  
Dural Arteriovenous Fistulas ◽  
History Of

OBJECTIVECranial dural arteriovenous fistulas (DAVFs) have been associated with dural sinus occlusion, and previous reports have suggested the association of hypercoagulability with some cases. But the prevalence of a hypercoagulable state has not been systematically analyzed in conjunction with laboratory markers and clinical manifestations, including history of thromboembolism or systemic malignancy. The authors hypothesize that laboratory or clinical evidence of a hypercoagulable state, including cancer, is commonly identifiable in consecutively identified patients with DAVFs, with implications for clinical management.METHODSThe retrospective cohort study included all patients older than 17 years with cranial DAVFs diagnosed at University of Chicago Medicine during a 6-year period, whose medical records and imaging results were reviewed for objective laboratory or clinical evidence of a hypercoagulable state, including malignancy. Each case was analyzed for implications on clinical management. Data were analyzed in relation to a systematic review of the literature on this association.RESULTSFifteen (88%) of 17 cases of DAVFs had laboratory (n = 8) or clinical evidence of a hypercoagulable state (thromboembolism [n = 8] or cancer [n = 6]). This hypercoagulability or cancer impacted clinical care in all 15 cases.CONCLUSIONSAn underlying hypercoagulable state manifested by laboratory testing or clinically, including cancer, is staggeringly common. It is important to recognize this association, along with its impact on the management of the DAVFs and systemic diseases.

scholarly journals Dural Arteriovenous Fistula with Retrograde Drainage into the Cortical Veins (Case Report)

2021 ◽  
pp. 116-125
Author(s):  
A. S. Filatov ◽  
E. I. Kremneva ◽  
R. N. Konovalov ◽  
V. V. Sin’kova ◽  
A. A. Lyaskovik ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Cerebral Hemisphere ◽  
Dural Arteriovenous Fistula ◽  
Brain Mri ◽  
Venous Hypertension ◽  
Occipital Artery ◽  
Type Ii ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
First Time

We present clinical case of a patient who was referred for brain MRI to clarify the cause of a first-time seizure. MRI examination showed cortical and medullary veins ectasia in the left cerebral hemisphere with multiple cerebral microbleeds around the medullary veins. The revealed changes were considered as a manifestation of regional venous hypertension, however, its cause remained unclear. We decided to perform non-contrast 3D-TOF angiography that revealed a dural arteriovenous fistula between the left occipital artery and the sigmoid venous sinus with retrograde drainage into cortical veins (Borden type II, Cognard type IIb). Early diagnosis and treatment of «aggressive» dural arteriovenous fistulas avoids the development of lifethreatening complications (an annual hemorrhage rate of 8,1%).

scholarly journals Rare case of dural arteriovenous fistula presenting by spontaneous acute subdural hematoma: A case report and review of literature

2020 ◽  
Vol 77 (2) ◽  
pp. 237-239
Author(s):  
Jagos Golubovic ◽  
Djula Djilvesi ◽  
Tomislav Cigic ◽  
Vladimir Papic ◽  
Bojan Jelaca ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Subdural Hematoma ◽  
Rare Case ◽  
Dural Arteriovenous Fistula ◽  
Neurological Deficits ◽  
Acute Subdural Hematoma ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Subdural Bleeding

Introduction. Dural arteriovenous fistulas represent pathological acquired bonds between the meningeal blood vessels (arteries) and drainage veins associated to them. These fistulas can vary in clinical presentations, from being asymptomatic to causing serious neurological deficits, depending mostly on the localization and size. Only one fourth of dural fistulas present themselves with intracranial bleeding. This hemorrhage is most frequently localized in subarachnoid space, occasionally intracerebrally, and seldom beneath the dura mater, ie subdurally. Case report. We presented a rare case of a patient with spontaneous acute subdural hematoma. After the initial treatment and consequent imaging methods, a diagnosis of a dural arteriovenous fistula was established. After the craniotomy for hematoma evacuation, the patient underwent an uneventful endovascular treatment. Despite the rarity of non-traumatic acute subdural hematoma caused by dural arteriovenous fistula, one should not overlook the possible pathogenesis and etiology in patients with spontaneous acute subdural hematoma. Even with the absence of the symptoms and signs of subdural bleeding, dural arteriovenous fistula, as a cause of it, should not be immediately ruled out. Conclusion. Despite the rarity of non-traumatic acute subdural hematoma being caused by dural arteriovenous fistulas, one should not immediately overlook the possible pathogenesis and etiology. Cautious approach is needed when treating such diseases even in the absence of typical symptoms.

scholarly journals Transarterial Wedged-catheter, Flow-arrest, N-butyl Cyanoacrylate Embolization of Three Dural Arteriovenous Fistulae in a Single Patient

2003 ◽  
Vol 9 (3) ◽  
pp. 283-290 ◽  
Author(s):  
S.M. Russell ◽  
H.H. Woo ◽  
P. K. Nelson
Keyword(s):  
Sinus Thrombosis ◽  
Memory Loss ◽  
Venous Drainage ◽  
Venous Access ◽  
Single Patient ◽  
Arteriovenous Fistulas ◽  
Unsteady Gait ◽  
Dural Arteriovenous Fistulas ◽  
History Of ◽  
Cortical Venous Drainage

The pathogenesis of dural arteriovenous fistulas (DAVFs) is currently unknown, with multiple DAVFs being rare. For patients with limited venous access secondary to sinus thrombosis, or for patients where parent sinus occlusion would not be tolerated, transvenous embolization may not be possible and other treatment methods must be considered. A 69-year-old female patient with a two-year history of progressive headaches, memory loss, and unsteady gait underwent cerebral angiography that revealed three separate DAVFs with congested cortical venous drainage overlying both frontal lobes. Using an application of a transarterial wedged-catheter, flow-arrest technique, N-butyl cyanoacrylate was deposited across all three pathologic arteriovenous connections providing a definitive cure. Transarterial NBCA embolization may provide curative treatment of DAVFs, and is of particular utility in situations where access to the draining venous structures is limited.

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