Endovascular embolization of cerebrospinal fluid-venous fistula: a comprehensive systematic review on its efficacy and safety for the management of spontaneous intracranial hypotension

Orscelik, Atakan; Senol, Yigit Can; Musmar, Basel; Kobeissi, Hassan; Bilgin, Gokce Belge; Zandpazandi, Sara; Bilgin, Cem; Pakkam, Madona; Brinjikji, Waleed

doi:10.1007/s10143-023-02264-1

Neurosurg Rev

2024

DOI: 10.1007/s10143-023-02264-1

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Endovascular embolization of cerebrospinal fluid-venous fistula: a comprehensive systematic review on its efficacy and safety for the management of spontaneous intracranial hypotension

Atakan Orscelik,

Yigit Can Senol,

Basel Musmar

et al.

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Safety and efficacy of transvenous embolization of cerebrospinal fluid-venous fistula in patients with spontaneous intracranial hypotension

Cagnazzo,

Ducros,

Risi

et al. 2024

Interv Neuroradiol

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Background Transvenous embolization is a recent treatment strategy for cerebrospinal fluid-venous fistulas (CSFVF), which are associated with spontaneous intracranial hypotension (SIH). Methods Participants were selected from a prospective database on patients with CSFVF that received transvenous Onyx embolization. All patients underwent a brain magnetic resonance imaging (MRI) before and after embolization with MRI follow-up performed at least 3 months after treatment. Clinical and MRI results after treatment were described. Results Twenty-one consecutive patients (median age 63 years, IQR = 58–71; females: 15/21 = 71.5%) with 30 CSFVF were included. Most lesions were situated between T9 and L1 (19/30 = 63%), 70% were right-sided, and 38% of the patients had multiples fistulas. Embolization was successful in all cases. The mean MRI SIH score before and after treatment was 6 (±2.5) and 1.4 (±1.6), respectively ( p < 0.0001). Twenty patients (90%) experienced improvement of their initial condition, of which 67% reported complete clinical recovery. The mean HIT-6 score decreased from 67 (±15) to 38 (±9) ( p < 0.0001), the mean amount of monthly headache days from 23.5 (±10) and 3.2 (±6.6) ( p < 0.0001), the visual assessment scale (VAS) for headache severity from 8 (±1.9) to 1.2 (±2) ( p < 0.0001), and the mean VAS for perception quality of life improved from 2.6 (±2.5) to 8.6 (±1.8) ( p < 0.0001). There were no major complications. The suspected rebound headache rate after treatment was 33%. Conclusion Transvenous embolization of CSFVF allowed high rates of clinical improvement with no morbidity related to the treatment.

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Safety and efficacy of transvenous embolization of cerebrospinal fluid-venous fistula in patients with spontaneous intracranial hypotension

Cagnazzo,

Ducros,

Risi

et al. 2024

Interv Neuroradiol

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show abstract

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Endovascular embolization of cerebrospinal fluid-venous fistula: a comprehensive systematic review on its efficacy and safety for the management of spontaneous intracranial hypotension

Cited by 1 publication

References 40 publications

Safety and efficacy of transvenous embolization of cerebrospinal fluid-venous fistula in patients with spontaneous intracranial hypotension

Safety and efficacy of transvenous embolization of cerebrospinal fluid-venous fistula in patients with spontaneous intracranial hypotension

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