Because of the nonspecific clinical presentation of the condition, patients are often referred to different. Tentorial dural arteriovenous fistula davf is a rare vascular disease, which accounts for less than 4% of all cases of intracranial davf. The backwards flow within the brain veins indicates that this is the bad type of dural arteriovenous fistula. Transvenous embolization of a dural carotidcavernous sinus fistula via the inferior ophthalmic vein. Fistula arteriovenosa dural intracraneal y hemorragia subaracnoidea perimesencefalica. Abstract spinal dural arteriovenous fistula, which is caused by the low flow shunts between dural arteries and the perimedullary venous system shows progressive myelopathy signs. Pdf fistula arteriovenosa dural intracraniana com drenagem. May 15, 2018 its also possible to develop an arteriovenous fistula after a piercing injury, such as a gunshot or stab wound.
Pdf dural arteriovenous fistula is a rare pathology with neurologic repercussions. Tentorial dural arteriovenous fistula davf is a rare vascular disease, which has high risk of intracranial hemorrhage. The patient then had the abnormal short circuit blocked by having an embolization procedure. They make up 1015% of all cerebral vascular malformations. Spinal dural arteriovenous fistula sdavf is the most common spinal vascular malformation, however it is still rare and underdiagnosed. Spinal dural arteriovenous fistulas american journal of. Normally, oxygenated blood flows to the tissue through arteries and capillaries. Involvement of dural arteries in intracranial arteriovenous. The role of transvenous embolization in the treatment of intracranial dural arteriovenous fistulas. Dural arteriovenous fistula davf dural arteriovenous fistulas are abnormal connections that form between an artery and a vein in the tough covering over the brain or spinal cord.
Dural arteriovenous fistulas symptoms and causes mayo. Dural arteriovenous fistula example emory healthcare. The malformations were classified by location into supratentorial and infratentorial. A total of 84 endovascular procedures were performed. Dural arteriovenous fistula radiology reference article.
It is usually asymptomatic, but may also be complicated by abscesses and superimposed infection. Headache is one of the nonspecific symptoms that could be associated with all types of davfs. Mar 16, 2012 tentorial dural arteriovenous fistula davf is a rare vascular disease, which accounts for less than 4% of all cases of intracranial davf. Arteriovenous fistula davf johns hopkins cerebrovascular. Fastulas arteriovenosas durales intracraneales insight. Patients with dural avfs typically present with a rumbling noise in one ear that follows the heartbeat, which is called a bruit. The symptoms of davfs vary depending on the location of davf.
Dural arteriovenous fistulas davfs are abnormal connections between an artery and a vein in the tough covering over the brain or spinal cord. Mr imaging findings of intracranial dural arteriovenous. Dural arteriovenous fistula this dural arteriovenous fistula of the superior sagittal sinus drains into subarachnoid veins and is classified as borden type iiib. Endovascular today issn 15511944 print and issn 2689792x online is a publication dedicated to bringing you comprehensive coverage of all the latest technology, techniques, and developments in the endovascular field. Pdf spinal dural arteriovenous fistula researchgate. Because of the high risk of intracranial hemorrhage, patients with tentorial davf need aggressive treatment. Transvenous embolization of a dural arteriovenous fistula of the cavernous sinus through the contralateral pterygoid plexus. Spinal arteriovenous fistulas avfs are extremely rare. Sally has a bachelors degree in biomedical sciences b.
Seventysix consecutive patients with dural ccfs were investigated in detail, all of whom were defined by angiography. Dural arteriovenous fistulas davfs are abnormal connections between an artery and a vein in the tough covering over the brain or spinal cord dura mater. You may also hear the acronyms sdavf spinal dural arteriovenous fistula or bdavf brain dural arteriovenous fistula. A spinal fistula, particularly spinal dural fistula, is an abnormal connection between an artery and a vein that are located near the covering of the spinal cord. This classification provides useful data for determination of the risk with each dural avf and enables decisionmaking about the appropriate therapy. Vascular malformations involving the brain are divided into arteriovenous malformations avm developmental venous anomalies dva cavernous malformations. Description an arteriovenous fistula is a disruption of the normal blood flow pattern. When a fistula occurs near the dura the covering material of the brain, it is a dural arteriovenous fistula. However, spinal angiography remains the gold standard in the diagnosis of sdavf. Intracranial arteriovenous malformations may receive part or all of their blood supply from meningeal branches of the external carotid, internal carotid, or vertebral arteries, although previous authors25,8, 10, 1517,20,21,24have suggested that such a meningeal contribution is infrequent. Dural arteriovenous fistula, central nervous system vascular. They are most commonly located in the dorsal or lumbar region.
Dural arteriovenous fistulas in the cavernous sinus. Pdf intracranial subarachnoid hemorrhage resulting from. The brain is surrounded by a tough fibrous cover called dura mater or dura. Vascular malformations involving the brain are divided into arteriovenous malformations avm developmental venous anomalies dva cavernous malformations capillary telangiectasia. Preauricular fistula is a benign congenital malformation of the preauricular soft tissues and may be isolated or associated with other congenital anomalies. Endovascular treatment of tentorial dural arteriovenous. We present two cases of tentorial davf which were successfully treated with single trial of transarterial embolization using onyx. Normal vascular anatomy and dural arteriovenous fistula davf. Clinical presentation is highly variable and depends on the location of the supplying and draining vessels, as well as the presence of complications see below. Venous drainage then occurs via an adjacent dural venous sinus, cortical vein, or both. Definition an arteriovenous fistula is an abnormal channel or passage between an artery and a vein.
Sep 30, 2015 tentorial dural arteriovenous fistula davf is a rare vascular disease, which has high risk of intracranial hemorrhage. Spinal dural arteriovenous fistula sdavf is a rare and enigmatic disease entity. An arteriovenous fistula is an abnormal connection between an artery and a vein. Microsurgery of dural arteriovenous fistulas basics and tricks. All patients were treated with embolisation, surgery, or both and 70% improved after fistula closure regardless of progression time. Spinal mri was diagnostic in 90% of these cases and arteriography in 100%.
When a fistula forms between an artery and a vein within the dura, it is called brain dural fistula, or brain dural arteriovenous fistula. Intracranial dural arteriovenous fistulas davfs, an. This covering is called dura, and so the full name spinal dural arteriovenous fistula. Doctors sometimes call avfs near the brain davfs, or dural arteriovenous fistulas, named after the covering around the brain where the avf is located. Surgical management of cerebral dural arteriovenous. Most dural arteriovenous fistulas present in adulthood and account for 1015% of all cerebral vascular malformations 6 clinical presentation. Pdf fistula arteriovenosa dural, lesion medular y disinergia. These are acquired lesions that occur most commonly without an obvious cause, but can be associated with trauma, surgery, tumors, or previous infections near the area of the lesion.
Fistula arteriovenosa dural, lesion medular y disinergia vesicoesfinteriana. Spinal dural arteriovenous fistula sdavf radiology. A dural arteriovenous fistula davf is a vascular anomaly formed by an abnormal connection between an artery within the tough covering of the brain dura mater and a. Arteriovenous fistula symptoms and causes mayo clinic. Join ucla interventional radiologist viktor szeder, md, phd, for a conversation about arteriovenous fistulas, which are abnormal connections between arteries. Mar 16, 2019 dural arteriovenous fistula davf dural arteriovenous fistulas are abnormal connections that form between an artery and a vein in the tough covering over the brain or spinal cord. Davf, is an abnormal connection of vessels in the tissues around the brain or spinal cord in which one or more arteries are directly connected to one or. The malformations may be classified on the basis of their arterial supply as pure pial, mixed pial. A cerebral dural arteriovenous fistula davf is an abnormal arteriovenous shunt, supplied primarily by dural feeding arteries, in which the fistulous connection occurs within the dural leaflets that surround the brain. An arteriovenous fistula avf is an abnormal connection between an artery and a vein. The source and extent of the meningeal arterial supply in patients with dural involvement were tabulated. Dural arteriovenous fistula and cerebral venous thrombosis. Spinal dural fistulas consist in an artery that penetrates into the dura mater and drains into a perispinal vein. Dural arteriovenous fistulas are fistulas connecting the branches of dural arteries to dural veins or a venous sinus.
Fistula dural arteriovenosa, malformaciones del sistema venoso. The word dura refers to the membrane that covers the brain. Dural arteriovenous fistulas articles case reports symptoms treatment, spain. Fistula arteriovenosa dural, lesion medular y disinergia vesicoesfinteriana dural arteriovenous fistula causing spinal cord injury and vesicosphincteric dyssynergia author links open overlay panel r. C cognard, y p gobin, l pierot, a l bailly, e houdart, a casasco, j chiras, j j merland. Intracranial dural arteriovenous fistulas surgical neurology. Dural arteriovenous fistulas with direct cortical venous drainage. The av shunt is located inside the dura mater close to the spinal nerve root where the arterial blood from a.
Spinal dural aretriovenous fistula is a treatable cause of mielopathy. Dural arteriovenous fistula davf boston medical center. The most common location of the fistula was the lower thoracic region and the most frequent type was dural 7 cases. Type v produced progressive myelopathy in 50% of cases. On the basis of the arterial blood supply they were further subdivided into pure pial, mixed pial dural, and pure dural lesions. Management of a series of patients treated at a neurology department.
Fistula arteriovenosa dural intracraneal y hemorragia elsevier. Dural arteriovenous fistula is a rare pathology with neurologic repercussions. Surgical management of cerebral dural arteriovenous fistulae. Post embolisation there was no flow to the fistula from bilateral middle meningeal arteries.
Dural arteriovenous fistula davf are a heterogeneous collection of conditions that share arteriovenous shunts from dural vessels. The borden classification of dural arteriovenous fistulas davf groups these lesions into three types based upon the site of venous drainage and the presence or absence of cortical venous drainage. A tiny catheter was placed into the site of abnormal connection by threading it up from the patients groin under xray guidance. This may happen if your wound is on a part of your body where a vein and artery are side by side. Fistula arteriovenosa dural, lesion medular y disinergia. Tentorial dural arteriovenous fistula treated using. A dural arteriovenous fistula davf or malformation, is an abnormal direct connection fistula between a meningeal artery and a meningeal vein or dural venous sinus. In this study, we sought to identify mr imaging finding differences between davf types classified on the basis of venous drainage patterns.
When there is a fistula in the brain, we call it an arteriovenous malformation avm. When a fistula forms between an artery and a vein within the dura, it is called brain dural fistula, or brain dural arteriovenous fistula, or bdavf, etc. Fassett and s k rammos and pankti patel and harsh parikh and william t. Endovascular treatment of tentorial dural arteriovenous fistulae. Its clinical suspicion is important, given that its outcome depends. Dural arteriovenous fistula presenting as thalamic dementia. Dural arteriovenous fistulas davf are abnormal connections between arteries and veins near the brain. Hemorrhage was present in 40% of cases of type iii dural avfs and 65% of type iv. Transvenous occlusion of dural cavernous sinus fistulas through the thrombosed inferior petrosal sinus.
Dural arteriovenous fistulas spain pdf ppt case reports. Venous drainage patterns are a major determinant of clinical outcome in intracranial dural arteriovenous fistula davf patients. Following the release of oxygen in the tissues, the. Dural arteriovenous fistulas symptoms and causes mayo clinic.
They most commonly affect elderly men and are classically found in the thoracolumbar region. Important considerations from initial evaluation to treatment planning. The clinical features and structural changes have been recognized since 1926, and the pathophysiology and the essentials of treatment since 1974, but up to the present day it is unknown why these fistulas develop. Patients with ccfs typically present with swelling and redness of one or both eyes in addition to a bruit. The purpose of this paper is to clarify the clinical course, with the dural carotid cavernous fistula ccf, featuring a pallet of symptoms, paying special attention to radiological findings.