Endovascular treatment resolves non-hemorrhagic brainstem dysfunction due to tentorial dural AV fistula

Panagiotopoulos, Vasileios; Kastrup, Oliver; Wanke, Isabel

doi:10.1016/j.jocn.2008.02.022

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…These appear as gait disturbance, diplopia, visual field defect, and progressive cognitive dysfunction. [5][6][7] Myelopathy is caused by congestive spinal veins, 8) while sensory disturbance by direct compression of brainstem caused by varices or dilated veins 9) has been reported.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Hemifacial Spasm Associated with a Tentorial DAVF Using Transarterial Onyx Embolization: A Case Report

Nakamura

Kuge

Yamaki

et al. 2022

JNET

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Objective: We describe a patient treated with transarterial Onyx embolization for a tentorial dural arteriovenous fistula (DAVF) who presented with hemifacial spasm (HFS).Case Presentation: A 56-year-old man suffered from right blepharospasm for 4 years, and the symptom gradually spread to the right side of his face with oculo-oral synkinesis. MRI of the brain revealed abnormal multiple flow voids at the surface of brainstem and cerebellar hemisphere. MRA (time of flight) and spoiled gradient recalled echo-revealed abnormal vessels at the posterior fossa indicated arteriovenous shunting. 3D-MRI fusion images showed that a dilated vein was in contact with the root exit zone (REZ) of the right facial nerve. The right carotid angiography displayed a complex tentorial DAVF on the right side. There were multiple feeding vessels drained to the tentorial sinus at the point where the inferior cerebellar vermian vein met, and severe venous congestion was noted. We diagnosed a tentorial DAVF and thought that this was responsible for the right HFS. We used neuroendovascular treatment for this lesion. After transarterial Onyx embolization, his right HFS diminished. MRI after treatment showed that the vein in contact with the REZ of the right facial nerve had shrank. Conclusion:We experienced a rare case of HFS associated with a DAVF. Our case supports that transarterial Onyx embolization can treat HFS associated with a tentorial DAVF. It is the first description of successful treatment that could be confirmed through postoperative MRI.

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Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Hemifacial Spasm Associated with a Tentorial DAVF Using Transarterial Onyx Embolization: A Case Report

Nakamura

Kuge

Yamaki

et al. 2022

JNET

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“…The tentorial dural arteriovenous fistulas (tDAVF) clinically present with hemorrhage, with reported rates from 58% to 92%, and neurological deficits in 79% to 92% of patients. The pathophysiology is retrograde leptomeningeal venous drainage with ensuing venous congestion (1,2,(11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

“…As described and characterized angiographically, dural arteriovenous fistulas (DAVFs) are lesions generally acquired and progressive with an Keywords dural arteriovenous fistulae, transient ischemic attack; endovascular treatment incidence of 10 to 15% Of all cerebral vascular lesions (1)(2)(3). They are divided into two main types: DAVFs that drain into a venous sinus with direct reflux to a cortical vein, or not of the venous sinus type (3).…”

Section: Introductionmentioning

confidence: 99%

“…The most frequent DAVFs is at the transversesigmoid junction (38%), and the cavernous sinus, followed by deep veins, the Superior sagittal sinus, superior petrous sinus, ethmoidal sinus, inferior petrous sinus and ethmoidal DAVFs (2,10). The etiology is controversial and the location of the DAVFs in very specific sites, and not throughout the dura mater.…”

Section: Introductionmentioning

confidence: 99%

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Tentorial dural arteriovenous fistulae presenting as transient ischemic attack

Zenteno¹,

Arnaout²,

Lee³

et al. 2019

roneuro

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Tentorial dural fistula with giant venous ampulae treated with embolisation and surgery. A case report

Borha

Emery

Courthéoux³

et al. 2010

Acta Neurochir

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Tentorial dural arteriovenous fistulas are rare and complex lesions in deep locations with unusual vascular anatomy and critical surrounding neuroanatomy. A rare case presenting a complex fistula with a giant venous draining ampulae, causing headaches and visual troubles is presented. We describe the case of a 52-year-old woman admitted in our department for headaches and visual troubles. Magnetic resonance imaging and cerebral angiography showed a tentorial dural arteriovenous fistula draining in a giant tentorial venous ampulae and leptomeningeal veins. The patient was embolised via an arterial route with a good clinical and radiological result. However, 4 days later she presented a sudden change of her clinical status with coma, left hemiparesis and a right midriasis. The cerebral computed tomography scan showed a huge occipital haemorrhagic mass and a severe cerebral oedema. An emergent surgical procedure was decided realising evacuation of the occipital haematoma and a complete resection of the giant venous ampoule. The neck of the ampulae was sutured and clipped at its dural entrance. Postoperatively a new embolisation was realised because of persistent of a small dural fistulae with occipital leptomeningeal drainage. The patient recovered rapidly with only a residual hemianopsy. Treatment of dural AV malformation represent a serious challenge. Our report describes an unusual case of a tentorial dural complex fistula treated by an endovascular procedure with secondary clinical aggravation that needed emergent surgical therapy. Even in a case for good immediate radiological result after endovascular procedure, dural arteriovenous fistulas with giant venous ampulae and important venous engorgement, need closed follow-up, because of the possibility of aggravation secondary to venous thrombosis and haemorrhage. Treatment and patophysiology of the aggravation mechanism are discussed.

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Endovascular treatment resolves non-hemorrhagic brainstem dysfunction due to tentorial dural AV fistula

Cited by 6 publications

References 11 publications

Endovascular Treatment of Hemifacial Spasm Associated with a Tentorial DAVF Using Transarterial Onyx Embolization: A Case Report

Endovascular Treatment of Hemifacial Spasm Associated with a Tentorial DAVF Using Transarterial Onyx Embolization: A Case Report

Tentorial dural arteriovenous fistulae presenting as transient ischemic attack

Tentorial dural fistula with giant venous ampulae treated with embolisation and surgery. A case report

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