Endovascular Treatment for Dural Arteriovenous Fistulae of the Superior Petrosal Sinus

Ng, Peter A.; Halbach, Van V.; Quinn, Roswell; Balousek, Peter A.; Caragine, Louis P.; Dowd, Christopher F.; Higashida, Randall T.; Wilson, Charles B.

doi:10.1227/01.neu.0000068790.37318.24

Cited by 53 publications

(44 citation statements)

References 11 publications

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“…We excluded DAVFs located in remote regions that drained into posterior fossa veins secondary to thrombosis of their "natural" outlets, in particular cavernous sinus or transversesigmoid lesions with venous occlusions. In the previously published literature, we found 30 cases of petrosal vein DAVFs 4,5,[7][8][9]13,16,21,30,33,[36][37][38]41,45,48,52,55,56,59,60 and 35 cases of medulla bridging vein DAVFs, 1,11,14,[17][18][19][20][22][23][24][25]31,32,35,39,40,43,46,50,51,53,58,61 all of which were well described with clinical and angiographic information. These previously reported cases were analyzed together, with special attention to their clinical characteristics.…”

Section: Methodsmentioning

confidence: 99%

Dural arteriovenous fistulas draining into the petrosal vein or bridging vein of the medulla: possible homologs of spinal dural arteriovenous fistulas

Mitsuhashi

Aurboonyawat

Pereira

et al. 2009

JNS

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Object Dural arteriovenous fistulas (DAVFs) with leptomeningeal venous reflux generally pose a high risk of aggressive manifestations including hemorrhage. Among DAVFs, there is a peculiar type that demonstrates direct drainage into the bridging vein rather than the dural venous sinus. The purpose of this study was to investigate the characteristics of DAVFs that drain directly into the petrosal vein or the bridging vein of the medulla oblongata. Methods Eleven consecutive cases of DAVFs that drained directly into the petrosal vein and 6 that drained directly into the bridging vein of the medulla were retrospectively reviewed. These cases were evaluated and/or treated at Hospital de Bicêtre in Paris, France, over a 27-year period. A review of previously reported cases was also performed. Results Both of these “extrasinusal”-type DAVFs demonstrated very similar characteristics. There was a significant male predominance (p < 0.001) for this lesion, and a significantly higher incidence of aggressive neurological manifestations including hemorrhage or venous hypertension than in DAVFs of the transverse-sigmoid or cavernous sinus (p < 0.001). This finding was considered to be attributable to leptomeningeal venous reflux. Regarding treatment, endovascular embolization (either transarterial or transvenous) is frequently difficult, and surgery may be an effective therapeutic choice in many instances. Conclusions Embryologically, both the petrosal vein and the bridging vein of the medulla are cranial homologs of the spinal cord emissary bridging veins that drain the pial venous network. The authors believe that DAVFs in these locations may be included in a single category with spinal DAVFs because of their similar clinical characteristics.

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Section: Methodsmentioning

confidence: 99%

Dural arteriovenous fistulas draining into the petrosal vein or bridging vein of the medulla: possible homologs of spinal dural arteriovenous fistulas

Mitsuhashi

Aurboonyawat

Pereira

et al. 2009

JNS

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“…19 Endovascular therapy is often necessary to manage effectively the pathological entities involving this sinus, such as dural arteriovenous fistulas. 2,6,7,9,10,12,13,17,27,29 The venous anatomy of the skull base and its variations are important in approaches to this region.…”

Section: Endovascular Treatment and Surgerymentioning

confidence: 99%

The relationship between the superior petrosal sinus and the porus trigeminus: an anatomical study

Tubbs

Mortazavi

Krishnamurthy

et al. 2013

JNS

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T he SPS is a small, narrow venous channel located at the junction between the middle and posterior cranial fossae. It is adjacent to many important intracranial structures, and its vicinity to these structures makes it an important landmark for surgical approaches to the skull base. It originates in the CS and passes dorsolaterally to drain into the transverse-sigmoid junction. The sinus runs in the superior petrosal sulcus and begins from the posterolateral base of the petrous ridge and travels at an anteromedial angle toward its apex, and is usually larger posteriorly and becomes smaller near its apex. 23 This sinus travels in the attached margin of the tentorium cerebelli 26 and receives drainage from the cerebellum, the inferior cerebral veins, and the veins of the tympanic cavity. 26,31 Since knowledge of such regional anatomy is important to the neurosurgeon, and the relationship of the SPS to the Meckel cave has not been stressed in the literature, the current study was undertaken.The relationship between the superior petrosal sinus and the porus trigeminus: an anatomical study Object. During intracranial approaches to the skull base, vascular relationships are important. One relationship that has received scant attention in the literature is that between the superior petrosal sinus (SPS) and the opening of the Meckel cave (that is, the porus trigeminus).Methods. Cadaver dissections were performed in 25 latex-injected adult cadaveric heads (50 sides). Specifically, the relationship between the SPS and the opening of the Meckel cave was observed. The goal was to enhance knowledge of the relationship between the SPS and the opening of the Meckel cave.Results. Of the 50 sides, 68%, 18%, and 16% of SPSs traveled superior to, inferior to, and around the opening to the Meckel cave, respectively. In the latter cases, a venous ring was formed around the proximal trigeminal nerve. No sinus entered the Meckel cave. In general, the porus trigeminus was narrowed on sides found to have an SPS that encircled this region. Sinuses that traveled only inferior to the porus were in general smaller than sinuses that traveled superior or encircled this opening. No statistically significant differences were noted between the various sinus relationships and sex, age, or side of the head.Conclusions. Knowledge of the relationship between the SPS and the opening of the Meckel cave may be useful to the skull base surgeon. Based on this study, some individuals may retain the early embryonic position of their SPS in relation to the trigeminal nerve.

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“…[1][2][3] Endovascular techniques allow both arterial and venous access to the site of the fistulous connection. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] DAVFs with leptomeningeal venous drainage or an associated venous varix are defined as high risk and are associated with a dismal natural history. 2,[19][20][21][22][23][24] High-risk fistulas typically present with hemorrhage or progressive neurologic deficits.…”

mentioning

confidence: 99%

Complications Related to Percutaneous Transarterial Embolization of Intracranial Dural Arteriovenous Fistulas in 40 Patients

Jiang²,

Zhang³

et al. 2009

AJNR Am J Neuroradiol

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Endovascular Treatment for Dural Arteriovenous Fistulae of the Superior Petrosal Sinus

Abstract: Endovascular treatment of dural arteriovenous fistulae of the superior petrosal sinus can result in cure when access to the site of the fistula can be achieved. Preoperative embolization is a safe and effective adjunct to minimize bleeding during open neurosurgery.

Cited by 53 publications

References 11 publications

Dural arteriovenous fistulas draining into the petrosal vein or bridging vein of the medulla: possible homologs of spinal dural arteriovenous fistulas

Dural arteriovenous fistulas draining into the petrosal vein or bridging vein of the medulla: possible homologs of spinal dural arteriovenous fistulas

The relationship between the superior petrosal sinus and the porus trigeminus: an anatomical study

Complications Related to Percutaneous Transarterial Embolization of Intracranial Dural Arteriovenous Fistulas in 40 Patients

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