Dural fistulas involving the cavernous sinus: results of treatment in 30 patients.

Halbach, Van V.; Higashida, R T; Hieshima, Grant B.; Reicher, Murray A.; Norman, David; Th, Newton

doi:10.1148/radiology.163.2.3562823

Cited by 215 publications

(106 citation statements)

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“…Given the benign features of low-flow CS DAVFs and possibility of spontaneous occlusion, some authors have advocated conservative treatments, including cervical carotid artery and jugular vein compressions, as first-line therapies for these lesions. 15,40 However, some cases present with intractable intraocular hypertension or reduced ocular perfusion pressure, thereby warranting more rapid interventions to prevent progressive vision loss. 36,40,49 Due to their unique anatomy and symptomatology, CS DAVFs are often categorized using the Barrow classification system.…”

Section: Comparison Of Cs Davfs and Ncs Davfsmentioning

confidence: 99%

Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review

Chen¹,

Lee

Ding³

et al. 2015

JNS

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C urrent treatment strategies for intracranial dural arteriovenous fistulas (DAVFs) include microsurgical ligation, transarterial or transvenous embolization, stereotactic radiosurgery (SRS), and various combinations of these therapeutic options. Endovascular therapy, most commonly performed via transvenous routes, has become the preferred treatment approach for DAVFs. 27,44,48 Due to the immediate obliteration that can be achieved with endovascular or surgical occlusion, SRS is typically reserved for lesions that cannot be obliterated with endovascular or surgical approaches, or for patients who pose a high surgical risk due to medical comorbidities. Therefore, published SRS series for DAVFs remain relatively few and comprise mostly retrospective, single-center studies.In this systematic review, we evaluate the obliteration rate of DAVFs in patients treated with SRS. We also compare obliteration rates between cavernous sinus (CS) and noncavernous sinus (NCS) DAVFs, and between DAVFs with and without cortical venous drainage (CVD), by using available data in the literature. Methods inclusion CriteriaIn our attempt to balance between the largest possible patient population and a relatively homogeneous cohort, the following inclusion criteria for this systematic review were devised: 1) the study must contain at least 5 patients abbreviatioNs AVM = arteriovenous malformation; CS = cavernous sinus; CVD = cortical venous drainage; DAVF = dural arteriovenous fistula; GKS = Gamma Knife surgery; LINAC = linear accelerator; NCS = noncavernous sinus; SRS = stereotactic radiosurgery; TSS = transverse and sigmoid sinus. obJeCt The goal of this study was to evaluate the obliteration rate of intracranial dural arteriovenous fistulas (DAVFs) in patients treated with stereotactic radiosurgery (SRS), and to compare obliteration rates between cavernous sinus (CS) and noncavernous sinus (NCS) DAVFs, and between DAVFs with and without cortical venous drainage (CVD). Methods A systematic literature review was performed using PubMed. The CS DAVFs and the NCS DAVFs were categorized using the Barrow and Borden classification systems, respectively. The DAVFs were also categorized by location and by the presence of CVD. Statistical analyses of pooled data were conducted to assess complete obliteration rates in CS and NCS DAVFs, and in DAVFs with and without CVD. results Nineteen studies were included, comprising 729 patients harboring 743 DAVFs treated with SRS. The mean obliteration rate was 63% (95% CI 52.4%-73.6%). Complete obliteration for CS and NCS DAVFs was achieved in 73% and 58% of patients, respectively. No significant difference in obliteration rates between CS and NCS DAVFs was found (OR 1.72, 95% CI 0.66-4.46; p = 0.27). Complete obliteration in DAVFs with and without CVD was observed in 56% and 75% of patients, respectively. A significantly higher obliteration rate was observed in DAVFs without CVD compared with DAVFs with CVD (OR 2.37, 95% CI 1.07-5.28; p = 0.03). CoNClusioNs Treatment with SRS offers favorable rates of D...

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Section: Comparison Of Cs Davfs and Ncs Davfsmentioning

confidence: 99%

Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review

Chen¹,

Lee

Ding³

et al. 2015

JNS

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“…6 However, endovascular management of these and other dural arteriovenous fistulas (DAVFs) is both curative and safe. 3,[17][18][19][20][21][22][23][24][25] In the present series, the diagnosis of MSF was complicated by a clinical presentation similar to that of a CCF. Misdiagno-sis on the basis of clinical presentation and/or noninvasive imaging may lead to the inappropriate dismissal of an MSF as a benign indirect CCF.…”

Section: Discussion/resultsmentioning

confidence: 98%

Marginal Sinus Arteriovenous Fistulas Mimicking Carotid Cavernous Fistulas: Diagnostic and Therapeutic Considerations

Turner¹,

Gonugunta²,

Kelly³

et al. 2007

American Journal of Neuroradiology

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SUMMARY:Marginal sinus fistulas (MSFs) are uncommon vascular anomalies. Occasionally, the dominant venous drainage is forced retrograde up the inferior petrosal sinus and into the cavernous sinus, causing chemosis, proptosis, and ocular hypertension, mimicking a carotid cavernous fistula. This atypical clinical presentation may lead to misdiagnosis and inappropriate hazardous treatment of an MSF. Identifying the site of the fistula and understanding the anatomy of the venous drainage are critical in providing appropriate, safe, and efficacious endovascular treatment.

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“…Complete regression or improvement of symptoms due to spontaneous thrombosis is reported in 25%-90% of cases. [17][18][19][20] Whereas these reports include all types of cavernous sinus fistula, a previous study on patients with Barrow type B fistulas and without embolization found clinical cure in 69.6% of patients and improvement in 13% of patients. 21 For many years balloon embolization was the criterion standard for the treatment of direct AVF of the cavernous sinus.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome after Coil Embolization of Cavernous Sinus Arteriovenous Fistulas: Fig 1.

Bink¹,

Goller²,

Lüchtenberg³

et al. 2010

AJNR Am J Neuroradiol

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Dural fistulas involving the cavernous sinus: results of treatment in 30 patients.

Cited by 215 publications

References 0 publications

Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review

Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review

Marginal Sinus Arteriovenous Fistulas Mimicking Carotid Cavernous Fistulas: Diagnostic and Therapeutic Considerations

Long-Term Outcome after Coil Embolization of Cavernous Sinus Arteriovenous Fistulas: Fig 1.

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