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1.
Multiple dural arteriovenous fistulae involving the cavernous and sphenoparietal sinuses 总被引:4,自引:0,他引:4
Watanabe T Matsumaru Y Sonobe M Asahi T Onitsuka K Sugita K Takahashi S Nose T 《Neuroradiology》2000,42(10):771-774
A 72-year-old woman who presented with a unilateral oculomotor nerve palsy was shown to have a very rare condition: multiple
dural arteriovenous fistulae (DAVF) involving the cavernous and sphenoparietal sinuses. The sphenoparietal DAVF was cured
completely by transarterial embolisation. Symptomatic relief was accomplished by this procedure. The cavernous sinus DAVF
progressed to acquire cortical venous drainage, and was obliterated completely by transvenous embolisation.
Received: 21 September 1999/Accepted: 3 February 2000 相似文献
2.
Intracranial dural arteriovenous fistulae with perimedullary venous drainage. Anatomical, clinical and therapeutic considerations 总被引:3,自引:3,他引:0
Ricolfi F Manelfe C Meder JF Arrué P Decq P Brugiéres P Cognard C Gaston A 《Neuroradiology》1999,41(11):803-812
We report five cases of intracranial dural arteriovenous fistula (DAVF) with perimedullary venous drainage. All the patients
presented with rapidly progressive myelopathy and three had autonomic disorders. The DAVF were on the tentorium cerebelli
(two cases), sigmoid (one), superior petrosal (one), and cavernous sinus (one). Slow venous drainage was directed through
dilated perimedullary cervical veins. The transverse sinus was occluded in two cases. MRI, performed in four cases, demonstrated
high signal on T2-weighted spin-echo sequences in the medulla oblongata and upper cervical spinal cord consistent with oedema,
which signal resolved after complete cure of the DAVF in three cases. Embolisation was performed in all cases. It was followed
by clinical deterioration in two cases and in the dramatic improvement in the other three, with complete clinical cure in
two. Extensive venous thrombosis may explain the deterioration observed in one case.
Received: 22 April 1998 Accepted: 15 September 1998 相似文献
3.
Tentorial dural arteriovenous fistulae: endovascular treatment with transvenous coil embolisation 总被引:3,自引:0,他引:3
Tentorial arteriovenous dural fistulae are uncommon. They are aggressive lesions: of all intracranial dural fistulae they
are the most likely to present with haemorrhage. Treatment options include surgical excision or interruption of leptomeningeal
draining veins and arterial embolisation in isolation or in combination with surgery. There has been one case report of treatment
by percutaneous transvenous coil embolisation. We describe successful transvenous coil embolisation of two tentorial dural
fistulae presenting with subarachnoid haemorrhage.
Received: 14 September 1998 Accepted: 6 October 1998 相似文献
4.
An 80-year-old man presented with a dural arteriovenous malformation (DAVM) involving the left lateral sinus. A carotid angiogram showed the lateral sinus to be occluded proximally and distally, with unusual retrograde venous outflow from the residual sinus to the cortical veins, including a dilated vein of Labbé. Single photon emission computed tomography showed reduced left frontal and temporal cerebral blood flow. We concluded that the risk of bleeding from the DAVM was high and that the patient needed to be treated immediately. However, his age made surgical removal of the DAVM hazardous and we therefore chose to treat him by transarterial and direct lateral sinus embolisation via a burr hole. 相似文献
5.
Endovascular therapy of arteriovenous fistulae with electrolytically detachable coils 总被引:5,自引:2,他引:3
Jansen O Dörfler A Forsting M Hartmann M von Kummer R Tronnier V Sartor K 《Neuroradiology》1999,41(12):951-957
We report our experience in using Guglielmi electrolytically detachable coils (GDC) alone or in combination with other materials
in the treatment of intracranial or cervical high-flow fistulae. We treated 14 patients with arteriovenous fistulae on brain-supplying
vessels – three involving the external carotid or the vertebral artery, five the cavernous sinus and six the dural sinuses
– by endovascular occlusion using electrolytically detachable platinum coils. The fistula was caused by trauma in six cases.
In one case Ehlers-Danlos syndrome was the underlying disease, and in the remaining seven cases no aetiology could be found.
Fistulae of the external carotid and vertebral arteries and caroticocavernous fistulae were reached via the transarterial
route, while in all dural fistulae a combined transarterial-transvenous approach was chosen. All fistulae were treated using
electrolytically detachable coils. While small fistulae could be occluded with electrolytically detachable coils alone, large
fistulae were treated by using coils to build a stable basket for other types of coil or balloons. In 11 of the 14 patients,
endovascular treatment resulted in complete occlusion of the fistula; in the remaining three occlusion was subtotal. Symptoms
and signs were completely abolished by this treatment in 12 patients and reduced in 2. On clinical and neuroradiological follow-up
(mean 16 months) no reappearance of symptoms was recorded.
Received: 17 March 1999 Accepted: 27 April 1999 相似文献
6.
Naito I Iwai T Shimaguchi H Suzuki T Tomizawa S Negishi M Sasaki T 《Neuroradiology》2001,43(8):672-676
We report six cases of transverse-sigmoid dural arteriovenous fistulae (TS DAVF) treated with percutaneous transvenous embolisation
through the occluded sinus. All patients had sinus occlusive lesions: an isolated sinus in five cases and a distal occlusion
of the affected sinus in one. Leptomeningeal retrograde venous drainage via the vein of Labbé or the sylvian vein was observed
in all patients with an isolated sinus. In five patients a microcatheter was easily passed through the occluded sinus. In
four of them, a complete angiographic cure was achieved by packing the sinus with coils. However, in one, sinus packing was
ineffective and surgical excision of the affected sinus was necessary. The microcatheter could not be passed through the occluded
sinus in one case, and direct packing of the isolated sinus was later required. In all cases, complete cure was achieved without
complications. This safe, not very invasive and highly effective treatment for TS DAVF with sinus occlusion is thus worth
trying when the occluded segment is relatively short.
Received: 11 August 2000 Accepted: 21 August 2000 相似文献
7.
Targeted compartmental embolization of cavernous sinus dural arteriovenous fistulae using transfemoral medial and lateral facial vein approaches 总被引:4,自引:0,他引:4
There are multiple transvenous approaches for treatment of cavernous dural arteriovenous fistulae (DAVF). The choice of a specific route depends on the compartment of the cavernous sinus involved in the fistula and its venous drainage. We used two different facial vein approaches to treat patients with cavernous DAVF draining directly into the anterior compartment of the cavernous sinus and thence to the superior ophthalmic vein. Other transvenous routes to the sinus were not apparent. Embolization was targeted to the involved compartment with preservation of those not embolized. No major post-procedure ophthalmic venous engorgement occurred. We believe that ideal treatment of cavernous DAVF is targeted transvenous coil deposition, which necessitates detailed knowledge of the anatomy of the facial veins and cavernous sinus compartments. 相似文献
8.
Brugières P Combes C el-Khoury C Decq P Heine P Meyrignac C Gaston A 《Neuroradiology》2000,42(4):267-271
We report aqueduct compression by venous ectasia in a 65-year-old man with a dural arterio-venous fistula in the posterior
cranial fossa draining into a superior vermian vein. Conventional and phase-contrast MRI showed the aqueduct stenosis and
the causative dilated vein.
Received: 9 November 1998 Accepted: 2 August 1999 相似文献
9.
B. Berthelsen 《European radiology》1992,2(5):452-458
The results of embolisation of dural arteriovenous fistulas draining into the transverse or sigmoid sinus were evaluated in 20 patients. Tinnitus was the main symptom in all patients although one also suffered from vertigo and sudden deafness. Nine patients were treated with PVA (polyvinylalcohol) alone and 11 with combined PVA and bucrylate (isobutyl-2-cyanoacrylate) in 1–9 procedures. Recurrence of symptoms, requiring repeated procedures was common but at subsequent clinical follow up 10 patients had no tinnitus, 5 were improved and only 5 experienced no change. Complications occured in six patients: four had transient neurological symptoms and one of these also developed a necrotic wound which later healed. One patient suffered from a cranial nerve palsy and one had an intracranial haemorrhage after a transvenous embolisation. This last patient recovered completely. The best clinical results were achieved in small fistulas and fistulas treated with combined bucrylate and PVA. 相似文献
10.
M. Cellerini M. Mascalchi S. Mangiafico G. P. Ferrito V. Scardigli G. Pellicanò N. Quilici 《Neuroradiology》1999,41(7):487-492
MRI and phase-contrast MR angiography (PC MRA) were obtained in 13 patients with angiographically confirmed intracranial
dural arteriovenous fistulae (DAVF). Three- and two-dimensional PC MRA was obtained with low (6–20 cm/s) and high (> 40 cm/s)
velocity encoding along the three main body axes. MRI showed focal or diffuse signal abnormalities in the brain parenchyma
in six patients, dilated cortical veins in seven, venous pouches in four with type IV DAVF and enlargement of the superior
ophthalmic vein in three patients with DAVF of the cavernous sinus. However, it showed none of the fistula sites and did not
allow reliable identification of feeding arteries. 3D PC MRA enabled identification of the fistula and enlarged feeding arteries
in six cases each. Stenosis or occlusion of the dural sinuses was detected in six of eight cases on 3D PC MRA with low velocity
encoding. In six patients with type II DAVF phase reconstruction of 2D PC MRA demonstrated flow reversal in the dural sinuses
or superior ophthalmic vein.
Received: 14 May 1998 Accepted: 15 December 1998 相似文献
11.
A failed embolisation of a spinal dural arteriovenous fistula (AVF), because a pedicular injection has not reached the initial
venous compartment, must be identified immediately, to allow prompt surgery and thus avoid clinical deterioration. The purpose
of our study was to determine the role of CT in confirming a complete cure just after embolisation with N -butyl cyanoacrylate (NBCA). Seven patients embolised for spinal dural AVFs with perimedullary venous drainage had an immediate
postembolisation CT scan. In six patients a complete cure was achieved, with a normal postembolisation angiogram in five cases.
Just after injection of NBCA, we were unable to determine on plain films whether or not the glue had reached the draining
vein in six of seven cases. The postembolisation CT showed various patterns: in two cured patients, the glue was visible in
the inner surface of the dura mater and therefore on the venous side. In five cases, the glue was approaching the dura mater
around the cord or seemed to reach its surface: in the four patients cured, the glue column was 7–18 mm high, whereas it was
less than 2 mm high in the patient with angiographic proof of recurrent fistula. The follow-up angiogram remains the only
way to confirm a durable cure. We suggest that immediate postembolisation CT may help in assessing endovascular treatment
of spinal dural AVFs.
Received: 27 May 1994 Accepted: 30 August 1995 相似文献
12.
Andrea Bink Joachim Berkefeld Marc Lüchtenberg Rüdiger Gerlach Tobias Neumann-Haefelin Friedhelm Zanella Richard du Mesnil de Rochemont 《European radiology》2009,19(6):1443-1449
To determine technical success and acute complication rates after endovascular coil packing of the cavernous sinus. Nineteen
patients presented with either direct (13) or dural (6) arteriovenous fistula (AVF) and were treated by means of coil embolization
of the cavernous sinus. The aim of treatment was complete obliteration of the fistula. In a retrospective study, the degree
of obliteration, regression of symptoms as well as complication rates were evaluated. Initial complete obliteration was achieved
in 12 patients, subtotal occlusion of the sinus in 6 and incomplete packing with major residual fistula in 1 of the patients.
Retreatment was successfully performed in two patients with early recurrence of AVF. Follow-up showed complete occlusion rates
in 16 and subtotal obliteration in 3 patients. Chemosis and exophthalmus regressed rapidly in all affected patients. Persistence
of cranial nerve deficits was observed in 11 cases. Postinterventional thrombosis of the ophthalmic vein was the only major
acute complication (n = 2). Coil embolization of the cavernous sinus in cases with AVF is a complex procedure that is technically
feasible and safe in the majority of cases. Adequate anticoagulation is recommended to avoid thrombembolic complications.
Long-term outcome has to be determined by further studies. 相似文献
13.
Treatment of a cavernous sinus dural arteriovenous fistula by deep orbital puncture of the superior ophthalmic vein 总被引:7,自引:2,他引:5
In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous
sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case
in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach
through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit,
permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible
for occlusion of a cavernous sinus dural arteriovenous fistula.
Received: 14 July 2000 Accepted: 11 October 2000 相似文献
14.
15.
Long-term changes in intracranial dural arteriovenous fistulae leading to worsening in the type of venous drainage 总被引:3,自引:1,他引:2
C. Cognard E. Houdart A. Casasco J. Gabrillargues J. Chiras J. J. Merland 《Neuroradiology》1997,39(1):59-66
We review seven patients with intracranial dural arteriovenous fistulae (ICDAVF), each altering the initial type of venous
drainage to one with a higher grading during long-term follow-up. Five were discovered due to symptoms of intracranial hypertension,
two due to changes in tinnitus and one case following subarachnoid haemorrhage. In five cases, cortical venous drainage developed
during the follow-up period. Three different mechanisms were observed: stenosis or thrombosis in the draining veins in 4 cases:
increased arterial flow in 2; and the appearance o a new fistula site or extension of the initial shunt in 2. Type I and type
II a fistulae which are not completely cured, require both close clinical observation and Doppler examinations in the follow-up
period. Any charge in the clinical pictures indicates a repeat angiogram. Stenosis of the venous drainage, forecasting later
worsening in the venous outlet, requires more thorough angiographic follow-up.
Received: 26 June 1995 Accepted: 16 February 1996 相似文献
16.
Introduction Cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) rarely cause venous infarction (VI) and/or intracranial hemorrhage
(ICH) despite the presence of cortical venous drainage (CVD). The present study investigated the characteristics of CS DAVFs
manifesting as VI/ICH.
Materials and methods Fifty-four patients treated for CS DAVFs were retrospectively studied.
Results Six patients presented with VI/ICH. Two of the three patients presenting with ICH had CVD only to the superficial sylvian
vein (SSV) or the deep sylvian vein (DSV). Three patients presenting with VI had multiple drainages, and angiography of these
patients showed a varix on the SSV, drainage into the DSV with agenesis of the second and third segment of basal vein of Rosenthal,
and thrombosis of the distal petrosal vein. CS DAVF with CVD only carries higher risk of VI/ICH than multiple drainages. Many
CS DAVFs presenting with VI, especially those with drainage into the petrosal vein, have multiple drainages in the early stage.
Thrombosis of the inferior and superior petrosal sinuses and superior orbital vein gradually increases pressure of the CVD,
and then, VI may occur. In contrast, CS DAVFs with CVD only from the beginning, common in the patients with drainage into
the SSVs and DSVs, are likely to cause ICH.
Conclusion Angiographic risk factors causing VI/ICH are CVD only, varix formation, agenesis of the second and third segment of basal
vein of Rosenthal, and thrombosis of the superior orbital vein, lateral half of the superior petrosal sinus, and distal CVD. 相似文献
17.
Objective
The aim of this study is to describe the technique and results of the transvenous approach for occlusion of cavernous dural arteriovenous fistulas (DAVFs) with Onyx.Methods
Eleven patients presenting with clinically symptomatic DAVFs, were treated between August 2005 and February 2007 at Beijing Tiantan Hospital. We were able to navigate small hydrophilic catheters and microguidwires through the facial vein or inferior petrosal sinus (IPS) into the ipsilateral cavernous sinus. After reaching the fistula site the cavernous sinus was packed with Onyx or combining with detachable platinum coils.Results
We were able to reach the fistula site and to achieve a good packing of Onyx or combining with coils within the arteriovenous shunting zone in 10 patients. The final angiogram showed complete occlusion of the arteriovenous fistula. Two (18.2%) patients developed a bradycardia during DMSO injection. No complications related to the approach were observed.Conclusions
Transvenous occlusion of cavernous DAVFs is a feasible approach, even via facial vein or via IPS. Onyx may be another option for cavernous packing other than detachable platinum coils. 相似文献18.
Many tentorial dural arteriovenous fistulae (TDAVF) present with intracranial haemorrhage. We report a patient who presented
with conjunctival injection. Transarterial embolisation of the TDAVF was undertaken with a wedged injection of a low concentration
of N-butyl cyanoacrylate, arresting the flow next to the proximal segment of the venous outlet. After three sessions, a complete
cure was achieved. We present a useful method which has not been reported previously.
Received: 13 December 1999 Accepted: 12 July 2000 相似文献
19.
Summary The case of a patient with a fistula between the left internal carotid artery and the cavernous sinus, and another fistula between the right external carotid artery and the cavernous sinus, is reported. The clinical symptomatology, which was of spontaneous onset, was unilateral and consisted of exophthalmos and injection of the conjunctiva on the left side. Almost complete remission occurred after angiography. 相似文献
20.
Hiro Kiyosue Hiromu Mori Yoshiko Sagara Yuzo Hori Mika Okahara Hirofumi Nagatomi Toshi Abe 《Neuroradiology》2009,51(3):175-181
Introduction This study aimed to define the patterns of basal cerebral venous drainage (BCVD) from cavernous sinus dural arteriovenous
fistulas (CSDAVFs).
Materials and methods Forty sets of selective angiographic data from 36 patients with spontaneous CSDAVFs (age range, 53–79 years) were retrospectively
analyzed for their drainage patterns. Three types of BCVD were observed, i.e., superolateral type, BCVD via the deep middle
cerebral vein or uncal vein; posterolateral type, BCVD via the superior petrosal sinus and petrosal vein; and posteromedial
type, BCVD via the bridging vein and the anterior pontomesencephalic vein. MR images and/or 3D-DSA images were also reviewed
when available.
Results BCVD from CSDAVF was found in 12 patients (30%), and the other drainage routes included the superior ophthalmic vein in 25
(63%), the inferior petrosal sinus in 17 (43%), the superficial middle cerebral vein in 17 (43%), intercavernous sinus in
15 (38%), the superior petrosal sinus in seven (18%), and pterygoid plexus in two (5%), respectively. In 12 patients with
BCVD, superolateral type was found in four (33%), posterolateral type in five (42%), and posteromedial type in seven (58%).
Four cases of posteromedial type were associated with other types of BCVD.
Conclusion CSDAVFs are often associated with BCVD via three different pathways. The posteromedial type via the bridging vein is the most
frequent type of BCVD. 相似文献