Classification Schemes of Cranial Dural Arteriovenous Fistulas

Gómez, Juan Francisco Cerón; Amin, Anubhav G.; Gregg, Lydia; Gailloud, Philippe

doi:10.1016/j.nec.2011.09.003

Cited by 46 publications

(42 citation statements)

References 21 publications

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“…The presence of intracavernous sinus thrombi is also in favor of the latter possibility. Partial spontaneous thrombosis of dural arteriovenous fistulas can result in modification of their drainage pathways and influence their clinical expression [13]. This phenomenon, which may explain the redistribution of flow towards the orbital veins and the onset of new ophthalmological symptoms in our patient, is consistent with the thrombi documented in the posterior aspect of her CS and the preferential drainage into the ophthalmic veins noted angiographically.…”

Section: Discussionsupporting

confidence: 87%

Transvenous coil embolization of an indirect, Barrow type D carotid-cavernous fistula in a 3-year-old with Down syndrome

Torok

Pearl

2015

J Pediatr Neuroradiol

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A 3-year-old girl with trisomy 21 presented with progressive proptosis, scleral injection, and pulsatility of her right eye 1 month following minimal blunt head trauma. Computed tomography suggested a carotid cavernous fistula (CCF), which was confirmed by digital subtraction angiography and further classified as an indirect, Barrow type D CCF. Treatment was proposed because of vision-threatening elevated intraocular pressures. Transvenous coil embolization of the CCF was successfully performed. The patient was discharged to home 2 days after the procedure with immediate clinical improvement of her proptosis and normalization of her intraocular pressures on follow-up ophthalmologic visit 2 wk later.

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Section: Discussionsupporting

confidence: 87%

Transvenous coil embolization of an indirect, Barrow type D carotid-cavernous fistula in a 3-year-old with Down syndrome

Torok

Pearl

2015

J Pediatr Neuroradiol

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“…4 Still rarer is an intracranial dAVF with spinal venous drainage (Cognard type V arteriovenous fistula). 5,6 What makes our case even more unusual is that type V dAVF typically presents with progressive myelopathy or subarachnoid hemorrhage, while our patient presented with an acute brainstem syndrome. Congestion with hemorrhage and ischemia secondary to intracranial dAVF is a very rare presentation, with fewer than 40 cases reported to date.…”

Section: Discussionmentioning

confidence: 87%

Clinical Reasoning: A 63-year-old man with gastroenteritis progressing to stupor and quadriparesis

2020

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A 63-year-old man with a history of chronic right-sided headaches and intermittent nausea presented to the emergency department with worsening headache, nausea, and nonstop vomiting for 12 hours. Headache history dated back to the patient's early 20s. Headaches were exclusively right-sided, throbbing, associated with right eye and neck pain, photophobia and osmophobia, but without autonomic features. They occurred several times per week. He underwent multiple dental procedures, chiropractic manipulations, and C2-3 discectomy, but these interventions did not provide lasting relief, and he relied on nonsteroidal anti-inflammatory drugs to control the pain. Four years prior to his current hospital admission, he started to experience lightheadedness on getting up that resolved with lying down. Two years prior, he noticed problems with balance and had several falls. Six months prior, he had profound nausea for a week and lightheadedness that prevented him from getting out of bed. The symptoms abated on their own, but he would wake up daily with mild nausea and lightheadedness ever since. His medical history was otherwise only significant for asthma, hypertension, and obstructive sleep apnea. On admission, the patient was diagnosed with gastroenteritis and treated with fluids and antiemetics. The vomiting stopped, but the headache continued, and he developed new neurologic signs over several days: diplopia on left gaze, weakness progressing to quadriparesis, and increasing unresponsiveness (family described him as being "completely out of it-comatose"). Questions for consideration: 1. What is the localization of these signs and symptoms? 2. What diagnostic tests would you perform now? GO TO SECTION 2

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“…К л а с с и ф и к а ц и я и т е ч е н и е Паттерн венозного дренирования определяет тяжесть симптомов и лежит в основе классификации ДАВФ (табл. 1, 2) [5,6].…”

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The unusual cause of stroke: Cerebral dural arteriovenous fistula

Kalinin

Хасанова

Ибатуллин

et al. 2015

RJTAO

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org/10.14412/2074-2711-2015-4-37-41 Необычная причина инсульта: церебральная дуральная артериовенозная фистула У пациентов с острым нарушением мозгового крово-обращения без значимых факторов риска всегда трудно оп-ределить причину заболевания, особенно если имеющиеся рутинные тесты не выявляют какого-либо этиологического фактора. В таких случаях, как правило, сложно выработать правильную стратегию вторичной профилактики, что ведет к высокой частоте рецидивов, стойкой утрате трудоспособ-ности и смерти. Осведомленность о необычных причинах инсульта важна для дифференциальной диагностики и пла-нирования дальнейшего диагностического поиска. Одной из таких причин является дуральная артериовенозная фис-тула (ДАВФ) -заболевание, диагностика которого базиру-ется исключительно на методах нейровизуализации.Церебральная ДАВФ -это патологический шунт меж-ду артериями твердой мозговой оболочки (ТМО) и веноз-ными синусами, менингеальными или кортикальными ве-нами. Среди всех интракраниальных артериовенозных мальформаций (АВМ) ДАВФ встречаются в 10-15% случа-ев, хотя точная ее частота неизвестна -в большинстве на-блюдений заболевание протекает бессимптомно. Фистулы следует отличать от паренхиматозных или пиальных АВМ по наличию питающей артерии от ТМО и отсутствию сосу-дистого клубка в паренхиме мозга. Большинство ДАВФ ма-нифестируют в зрелом возрасте и располагаются в попереч-ном, сигмовидном или кавернозном синусах. Дебют ДАВФ с агрессивных неврологических симптомов более характе-

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Classification Schemes of Cranial Dural Arteriovenous Fistulas

Cited by 46 publications

References 21 publications

Transvenous coil embolization of an indirect, Barrow type D carotid-cavernous fistula in a 3-year-old with Down syndrome

Transvenous coil embolization of an indirect, Barrow type D carotid-cavernous fistula in a 3-year-old with Down syndrome

Clinical Reasoning: A 63-year-old man with gastroenteritis progressing to stupor and quadriparesis

The unusual cause of stroke: Cerebral dural arteriovenous fistula

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