Dural arteriovenous fistula associated with neoplastic dural sinus thrombosis: two cases

Vilela, Pedro; Willinsky, Robert A.; terBrugge, Karel G.

doi:10.1007/s002340100570

Cited by 27 publications

(21 citation statements)

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“…22) The downstream sinus obstruction may act as a trigger, changing the local hemodynamics and producing flow turbulence and/or venous hypertension. 20) These hemodynamic changes may contribute to the development of dural AVFs. Most cases of dural sinus obstruction or invasion by the tumor are not associated with dural AVF, so dural sinus obstruction or thrombosis cannot be the only reason for the presence of acquired dural AVFs.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Dural Arteriovenous Fistula Associated With Meningioma: Spontaneous Disappearance After Tumor Removal-Case Report-

Ahn

Lee

Cho

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A 45-year-old woman presented with a non-dominant transverse-sigmoid sinus dural arteriovenous fistula (AVF) associated with convexity meningioma on the same side. The dural AVF disappeared spontaneously after surgical removal of the meningioma, even though there was no manipulation of the dural AVF. Dural AVFs are usually acquired lesions, and may develop after trauma, surgery, and dural sinus thrombosis. Dural AVFs of the acquired origins are rarely associated with brain tumor. Dural AVFs associated with a tumor may develop even in the absence of sinus occlusion.

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Section: Discussionmentioning

confidence: 99%

“…2,4,5,7,9,10,13,16,19) Tumors causing occlusion of the major sinuses are rarely associated with dural AVFs, suggesting that the induced sinus occlusion may be the cause of the dural AVF. 1,6,[20][21][22] The most common tumor is meningioma. 1,6,18,19,22) Dural AVFs without sinus occlusion are rarely reported.…”

Section: Introductionmentioning

confidence: 99%

Dural Arteriovenous Fistula Associated With Meningioma: Spontaneous Disappearance After Tumor Removal-Case Report-

Ahn

Lee

Cho

et al. 2003

Neurol. Med. Chir.(Tokyo)

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“…Predisposing causes have been reported to be the presence of an intracranial brain tumor [3], a past history of intracranial surgery [6], head trauma [2], and brain infarction [4]. The most frequent brain tumor in patients with DAVFs is meningioma, which commonly develops adjacent to, and invades into, the dural sinuses [3,5,7,8]. To our knowledge, there have been no case reports of an intracranial DAVF associated with a spinal tumor.…”

Section: Dear Editormentioning

confidence: 95%

Intracranial dural arteriovenous fistula associated with a spinal tumor: a case report

et al. 2015

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Dear Editor,We would like to present the case of a patient with a transverse-sigmoid dural arteriovenous fistula (DAVF) associated with a spinal dumbbell schwannoma.Intracranial DAVFs are characterized by an arteriovenous (AV) shunt between the dural arteries and major intracranial dural sinuses [1]. Predisposing causes have been reported to be the presence of an intracranial brain tumor [3], a past history of intracranial surgery [6], head trauma [2], and brain infarction [4]. The most frequent brain tumor in patients with DAVFs is meningioma, which commonly develops adjacent to, and invades into, the dural sinuses [3,5,7,8]. To our knowledge, there have been no case reports of an intracranial DAVF associated with a spinal tumor.A 70-year-old female had become aware of a 'floating' gait 10 years prior to admission and later noticed bilateral pulsating tinnitus 2 years prior to admission. On admission, neurological examination revealed slight right spastic hemiparesis, sensory disturbances in the peripheries of the upper and lower extremities, and the Romberg sign.Spinal MR imaging revealed an extramedullary spinal dumbbell tumor, which significantly compressed the spinal cord at the C2 level (Fig. 1). There were many flow voids in the posterior cervical muscle layers around the tumor. Digital subtraction angiography revealed a right transverse-sigmoid DAVF without cortical venous reflux. There were multiple AV connections between the dural arteries and the transverse and sigmoid sinuses mainly at the sinus confluence; these dural branches were fed predominantly by the right vertebral artery as well as the bilateral maxillary and occipital arteries. Contrast-enhanced CT revealed that the right internal carotid vein was severely compressed at the right C2 level between the spinal tumor and anterior deep cervical muscles originating from the right styloid process. As a result, the right internal carotid vein was thrombosed, and the thrombus progressed into the right jugular foramen to the sigmoid sinus (Fig. 1d). Arterial blood flow into the DAVF drained out via the enlarged right condylar emissary vein into the deep cervical vein.We planned to treat the DAVF with endovascular embolization before open surgery because there was massive venous drainage around the tumor and severe bleeding during tumor removal was predicted. First, dural arteries were occluded with NBCA via a transarterial approach. Then, the deep cervical vein was occluded with NBCA via a transvenous approach. Finally, the right transverse and sigmoid sinuses were packed with coils, leading to the occlusion of the DAVF.In the second stage, we performed open surgery via a posterior midline approach. During surgery, bleeding was wellcontrolled because most of the deep cervical veins were occluded with NBCA. The dumbbell tumor, which was mostly located in the epidural space, was extensively removed, piece by piece, leading to successful decompression of the spinal cord. Total blood loss was 312 ml. The pathological diagnosis was schwannoma.

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“…Etiologically, DAVF is revealed secondary to causes such as trauma, inflammation, or sinus thrombosis [5][6][7][8] . However, most causes are idiopathic and independent of the preceding hematological and immunological impairments.…”

Section: Hypothesismentioning

confidence: 99%

“…It may be reasonable to consider the cause of inflammation to the infection of adjacent tissue such as sinusitis and mechanical inflammation after trauma (including catheter intervention). Sinus thrombosis is occasionally observed before the occurrence of DAVF 7 , however, such thrombosis might be the result of focal inflammation. In most cases with DAVF, inflammation will develop undetected or as an autoimmune allergic reaction.…”

Section: Hypothesismentioning

confidence: 99%

Hypothetical Mechanism of the Formation of Dural Arteriovenous Fistula – The Role and Course of Thrombosis of Emissary Vein and Sinuses

Miyachi¹

2012

Venous Thrombosis - Principles and Practice

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Dural arteriovenous fistula associated with neoplastic dural sinus thrombosis: two cases

Cited by 27 publications

References 0 publications

Dural Arteriovenous Fistula Associated With Meningioma: Spontaneous Disappearance After Tumor Removal-Case Report-

Dural Arteriovenous Fistula Associated With Meningioma: Spontaneous Disappearance After Tumor Removal-Case Report-

Intracranial dural arteriovenous fistula associated with a spinal tumor: a case report

Hypothetical Mechanism of the Formation of Dural Arteriovenous Fistula – The Role and Course of Thrombosis of Emissary Vein and Sinuses

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