Dural arteriovenous fistulas at the craniocervical junction: a systematic review

Zhao, Jingjing; Xu, Feng; Ren, Jinma; Manjila, Sunil; Bambakidis, Nicholas C.

doi:10.1136/neurintsurg-2015-011775

Cited by 74 publications

(90 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other studies also reported that SAH was a common presenting symptom in CCJ AVF. 15,16 In Table 5, we summarized published CCJ AVF case series with hemorrhagic presentation. Historically, an ascending drainage route into an intracranial vein and venous varices were considered the causes of SAH.…”

Section: Clinical Presentation and Angiographic Typesmentioning

confidence: 99%

“…Historically, an ascending drainage route into an intracranial vein and venous varices were considered the causes of SAH. 1,[4][5][6]15,16 In addition, some authors have mentioned that higher venous flow rates are associated with intracranial drainage and the formation of varices leading to SAH. 5,6 In contrast, A and B).…”

Section: Clinical Presentation and Angiographic Typesmentioning

confidence: 99%

See 1 more Smart Citation

Angioarchitecture of arteriovenous fistulas at the craniocervical junction: a multicenter cohort study of 54 patients

Hiramatsu

Sugiu

Ishiguro

et al. 2018

Journal of Neurosurgery

120

View full text Add to dashboard Cite

OBJECTIVE The aim of this retrospective multicenter cohort study was to assess the details of the angioarchitecture of arteriovenous fistulas (AVFs) at the craniocervical junction (CCJ) and to determine the associations between the angiographic characteristics and the clinical presentations and outcomes. METHODS The authors analyzed angiographic and clinical data for patients with CCJ AVFs from 20 participating centers that are members of the Japanese Society for Neuroendovascular Therapy (JSNET). Angiographic findings (feeding artery, location of AV shunt, draining vein) and patient data (age, sex, presentation, treatment modality, outcome) were tabulated and stratified based on the angiographic types of the lesions, as diagnosed by a member of the CCJ AVF study group, which consisted of a panel of 6 neurointerventionalists and 1 spine neurosurgeon. RESULTS The study included 54 patients (median age 65 years, interquartile range 61-75 years) with a total of 59 lesions. Five angiographic types were found among the 59 lesions: Type 1, dural AVF (22 [37%] of 59); Type 2, radicular AVF (17 [29%] of 59); Type 3, epidural AVF (EDAVF) with pial feeders (8 [14%] of 59); Type 4, EDAVF (6 [10%] of 59); and Type 5, perimedullary AVF (6 [10%] of 59). In almost all lesions (98%), AV shunts were fed by radiculomeningeal arteries from the vertebral artery that drained into intradural or epidural veins through AV shunts on the dura mater, on the spinal nerves, in the epidural space, or on the spinal cord. In more than half of the lesions (63%), the AV shunts were also fed by a spinal pial artery from the anterior spinal artery (ASA) and/or the lateral spinal artery. The data also showed that the angiographic characteristics associated with hemorrhagic presentations-the most common presentation of the lesions (73%)-were the inclusion of the ASA as a feeder, the presence of aneurysmal dilatation on the feeder, and CCJ AVF Type 2 (radicular AVF). Treatment outcomes differed among the angiographic types of the lesions. CONCLUSIONS Craniocervical junction AVFs commonly present with hemorrhage and are frequently fed by both radiculomeningeal and spinal pial arteries. The AV shunt develops along the C-1 or C-2 nerve roots and can be located on the spinal cord, on the spinal nerves, and/or on the inner or outer surface of the dura mater.

show abstract

Section: Clinical Presentation and Angiographic Typesmentioning

confidence: 99%

Section: Clinical Presentation and Angiographic Typesmentioning

confidence: 99%

Angioarchitecture of arteriovenous fistulas at the craniocervical junction: a multicenter cohort study of 54 patients

Hiramatsu

Sugiu

Ishiguro

et al. 2018

Journal of Neurosurgery

120

View full text Add to dashboard Cite

show abstract

“…10) In contrast, it has been stated that approximately 40% of DAVFs at the CCJ presented with SAH, and the presence of a varix and ascending venous drainage were significantly associated with SAH. 11,12) The angioarchitecture of our case is distinguished from that of typical DAVF where there are shunt points on the dura mater. In our case, we consider that not dural arteries but rather pial arterial network and the feeder aneurysm were mainly involved in the pathogenesis of SAH, and diagnosed as intradural RAVF.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Therapy of Radicular Arteriovenous Fistula at the Craniocervical Junction Fed by the Posterior Inferior Cerebellar Artery

Miyata

Iihoshi

Koyanagi

et al. 2017

JNET

View full text Add to dashboard Cite

Objective: Arteriovenous fistula (AVF) at the craniocervical junction (CCJ) is a rare intracranial vascular disorder that is one cause of subarachnoid hemorrhage (SAH). We report on a rare case of AVF at the CCJ, which was mainly supplied by a branch of the posterior inferior cerebellar artery (PICA).Case Presentations: A man in his seventies presented with severe SAH. Angiography revealed that the shunt point was placed in the vicinity of the intradural radicular vein of the right C1 nerve root, and that the C1 radicular artery (C1 RA) was also feeding the AVF. An aneurysm on the PICA branch feeding the shunt was considered a bleeding point. Taking the radiological findings into account, we made the diagnosis of radicular AVF at the CCJ. Transarterial glue embolization obliterated the aneurysm. Brain magnetic resonance (MR) imaging, however, demonstrated infarcts localized in the posterior part of the upper cervical cord and the cerebellum. Conclusion:Arterial anastomotic channels around the CCJ can be the source of ischemic events after glue embolization.

show abstract

“…3) According to other studies, the direction of an outflow affects symptoms; hemorrhage initially occurred in many patients with ascending outflow tracts, and myelopathy in those with descending outflow tracts. [2][3][4] The spontaneous course remains unclear due to an extremely small number of patients, and no study has reported the incidence or timing of additional hemorrhage. Treatment should be indicated for the patients with progressive myelopathy.…”

Section: Case Presentationmentioning

confidence: 99%

“…According to a national survey in Japan, the annual incidence of dAVF is 0.29 per 100,000 persons, and CCJ dAVF accounts for 2.4% of all patients with dAVF (annual incidence: 0.7 per 10,000,000 persons). 1) Zhao et al reviewed 56 patients with CCJ dAVF, 2) and reported that dAVF was more frequent in females, whereas CCJ dAVF was more frequent in males (male-tofemale ratio: 3:1). Myelopathy initially occurred in many patients with dAVF of the thoracic spinal cord or lower, whereas SAH initially developed in many patients with USA) with a slightly flexed tip was inserted into the main feeder using CHIKAI microwire 0.010 (Asahi-Intec, Nagoya, Aichi, Japan).…”

Section: Case Presentationmentioning

confidence: 99%

A Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction in Whom Endovascular Treatment Was Initially Performed, Followed by Surgical Management

Kaneko

Shibata

Kitahashi

et al. 2018

JNET

View full text Add to dashboard Cite

Objective: Dural arteriovenous fistulae at craniocervical junction (CCJ dAVF) cause subarachnoid hemorrhage (SAH).We present a case of CCJ dAVF with SAH in which endovascular treatment was initially performed, followed by surgical management, leading to radical cure.Case Presentation: Transarterial embolization was initially performed because of unfavorable clinical condition of the patient, resulted in main feeder occlusion. As this made the shunting point clearer, surgical drainer occlusion consequently facilitated, and radical cure could be achieved. Conclusion:To treat CCJ dAVF, endovascular treatment and surgical management were performed. The former alone did not result in radical cure, but decreased the shunt volume, facilitating the assessment of vascular anatomy.

show abstract

Dural arteriovenous fistulas at the craniocervical junction: a systematic review

Cited by 74 publications

References 29 publications

Angioarchitecture of arteriovenous fistulas at the craniocervical junction: a multicenter cohort study of 54 patients

Angioarchitecture of arteriovenous fistulas at the craniocervical junction: a multicenter cohort study of 54 patients

Endovascular Therapy of Radicular Arteriovenous Fistula at the Craniocervical Junction Fed by the Posterior Inferior Cerebellar Artery

A Patient with a Dural Arteriovenous Fistula at the Craniocervical Junction in Whom Endovascular Treatment Was Initially Performed, Followed by Surgical Management

Contact Info

Product

Resources

About