Hemodynamic status and treatment of aggressive dural arteriovenous fistulas.
Acta Neurochir Suppl
; 94: 123-6, 2005.
Article
in En
| MEDLINE
| ID: mdl-16060251
ABSTRACT
In this study the hemodynamic status and treatment modality of aggressive dural arteriovenous fistulas (dAVFs) was evaluated. Of 145 intracranial dAVFs treated in our clinic, there were 38 aggressive lesions presenting with hemorrhage, infarction, seizures, and symptoms of increased intracranial pressure. They included 3 (5% of all cavernous sinus lesions) cavernous sinus, 24 (44%) transverse-sigmoid and superior sagittal sinus, and 11 (46%) direct cortical types of dAVFs. Of these 38 aggressive lesions, retrograde leptomeningeal venous drainage was disclosed in 35 lesions, and retrograde sinus drainage in 3. Eighteen cases were treated only with endovascular procedures, 7 with surgical interventions, and 13 with combined endovascular and surgical procedures. Angiographic results were complete obliteration in 66% of the cases, subtotal and partial obliteration in 34%. Clinical outcome was GR (good recovery) in 58% of cases, MD (moderate disability) in 18%, SD (severe disability) in 13%, VS (vegetative state) in 8%, and D (death) (due to acute cardiac infarction) in 3%. Symptomatic procedural complication occurred in 3 cases. In conclusion, aggressive dural AVF resulted from retrograde leptomeningeal venous drainage. Combined surgical and endovascular treatment played the leading part in the management of this aggressive type of lesion.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Vascular Surgical Procedures
/
Arteriovenous Fistula
/
Risk Assessment
/
Neurosurgical Procedures
/
Central Nervous System Vascular Malformations
/
Embolization, Therapeutic
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
Acta Neurochir Suppl
Year:
2005
Document type:
Article