Multiple Dural Arteriovenous Fistulas Presenting as Pulsatile Tinnitus Treated with External Manual Compression

Oh, Se-Joon; Chon, Yong-Il; Kong, Soo-Keun; Goh, Eui-Kyung

doi:10.7874/jao.2017.00115

Cited by 6 publications

(8 citation statements)

References 14 publications

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“…The PAA originates from an ECA branch above the OA, travels to the space between the parotid gland and belemnoid, and then through the groove between the mastoid process and auricular cartilage[ 13 ]. Participation of the PAA in a DAVF is relatively rare but is reported to cause tinnitus[ 14 , 15 ], as in the present case. Although embolization therapy was performed for the MMA and OA, the disease was not cured.…”

Section: Discussionmentioning

confidence: 63%

Ear ischemia induced by endovascular therapy for arteriovenous fistula of the sigmoid sinus: A case report

Li¹,

Zhang²,

Gao³

et al. 2021

WJCC

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BACKGROUND Arteriovenous fistula of the sigmoid sinus is an abnormal connection of arteries with the sigmoid sinus. Endovascular treatments of such lesions are considered safe and with low rates of complications. CASE SUMMARY A 62-year-old female patient underwent endovascular treatment of an arteriovenous fistula of the right sigmoid sinus on February 7, 2017, but her tinnitus was not cured. She was admitted to the Beijing Tiantan Hospital, Capital Medical University, on March 20, 2017, and her pre-operative diagnosis, by digital subtraction cerebral angiography, was arteriovenous fistula of the sigmoid sinus. She underwent endovascular embolization of the distal occipital artery and posterior auricular artery using Onyx-18. The arteriovenous fistula of the sigmoid sinus was cured, and her tinnitus disappeared, but ischemia of the upper 2/3 of the right auricle occurred without hearing loss. The patient received treatment to improve microcirculation, in addition to fluid supplementation, analgesia, and hyperbaric oxygen, and the swelling due to ischemia in the right auricle did not progress further. The patient reported no tinnitus , and the right auricle had returned to normal 3 years later. CONCLUSION Ischemic complications of vital organs should be considered when performing embolization procedures for arteriovenous fistulas of cerebral sinuses. Compensation of the organs should be evaluated before the operation, and the related treatment regimens should be planned.

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Section: Discussionmentioning

confidence: 63%

Ear ischemia induced by endovascular therapy for arteriovenous fistula of the sigmoid sinus: A case report

Li¹,

Zhang²,

Gao³

et al. 2021

WJCC

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“…19 The current standard treatment consists of endovascular embolization and/or neurosurgical destruction when necessary. 19,34 Our patient 5 had a DAVF which only be treated partially by embolization due its complex location. The tinnitus still persists but tolerable.…”

Section: Vascular Originmentioning

confidence: 87%

“…Of arteriovenous origin, DAVF, counted as a rare cause of tinnitus, causing2%-20% of pulsatile tinnitus cases. 34 It is usually an acquired, abnormal connection between an artery and vein without an intervening nidus, located along the dura or within a dural sinus. 17 There are 2 classification systems for DAVF.…”

Section: Vascular Originmentioning

confidence: 99%

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Somatosound: A review with report of 9 cases with long-term follow-up

Han¹,

Lee²,

Ryu³

et al. 2021

NeuroAsia

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Somatosound (somatic tinnitus) is associated with vascular, musculoskeletal, respiratory, or temporomandibular joint disorders. Several studies of its management have been widely reported, but only few presented long-term follow-up results. The purposes of this paper are to review the causes and management, present cases with long-term follow-up, together with previously reported cases in literatures. We treated nine patients with somatosound of vascular, hematologic, endocrinologic, muscular, and cervical origin. Follow-up were conducted routinely, and the final results were collated in 3 to 11 years. Patients with non-life-threatening causes were given counseling and palliative management. Their tinnitus becomes tolerable, gradually decreased, and even disappeared. Patients with life-threatening causes were treated immediately. Among all, there were three cases which to the best of our knowledge, are the first reported of its causes. One case was caused by a compensatory of increasing blood flow in internal carotid artery (ICA) secondary to contralateral ICA stenosis. Another had a combination of anemia and an ipsilateral jugular bulb diverticulum. The tinnitus disappeared after the anemia treated. The last was patient with hyperthyroidism. The tinnitus disappeared by controlling the condition. Even when the causes are benign and the available treatments may carry risks, the patients should not be left unmanaged. Symptomatic treatment should be given, such as counseling, sound therapy, and palliative management. Our long-term observation indicated that overall outcomes are positive when the etiologies are identified early and managed properly.

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“…In clinical terms, intracranial MDAVFs are considered to follow a relatively malignant evolution, and their hemodynamics, angioarchitecture and imaging manifestations are complex ( 7 , 8 ). Affected patients exhibited higher incidence rates of hemorrhage and neurological deficits, and aggressive treatments should therefore be used for therapy ( 2 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

Progress in research on intracranial multipleï¿½duralï¿½arteriovenous fistulas (Review)

Guo

Zhao

et al. 2017

biom rep

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Intracranial multiple dural arteriovenous fistulas (MDAVFs) are rare lesions that are difficult to treat. The key factors involved in the development of MDAVFs remain unknown. At present, the majority of reports on intracranial MDAVFs are confined to case reports and small case series, and thus understanding of MDAVFs is limited. The current review assesses the available literature to date with the aim of reviewing the progress in research on intracranial MDAVFs. Intracranial MDAVFs may be divided into two types: Synchronous and metachronous. While the exact pathogenesis of MDAVFs is unknown, a number of possible mechanisms are considered relevant. The first is that MDAVFs develop following recanalization of a large sinus thrombosis that involves several sinuses. The second possibility is that a pre-existing DAVF may induce sinus thrombosis or venous hypertension, resulting in a new MDAVF. The third is that MDAVFs are caused by increased angiogenic activity, which may induce the development of MDAVFs. Intracranial MDAVFs have a malignant clinical course, and their symptoms generally rapidly progress following onset. It is therefore important to identify intracranial MDAVFs at an early stage. A number of imaging technologies, including computed tomography (CT), magnetic resonance imaging (MRI), digital subtraction angiography (DSA) and single-photon emission computed tomography (SPECT), may be used to detect MDAVFs. Of these, CT and MRI provide information on brain morphology, SPECT provides brain blood flow information, and DSA is the gold standard that may be used to identify angioarchitecture and hemodynamics. MDAVFs require timely and aggressive treatment, which may include endovascular embolization, surgical resection, radiosurgery and conservative treatment, and in some cases, combined treatments are required. Appropriate and aggressive treatment regimens can markedly improve neurological deficits and cognitive function in patients with MDAVFs.

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Multiple Dural Arteriovenous Fistulas Presenting as Pulsatile Tinnitus Treated with External Manual Compression

Cited by 6 publications

References 14 publications

Ear ischemia induced by endovascular therapy for arteriovenous fistula of the sigmoid sinus: A case report

Ear ischemia induced by endovascular therapy for arteriovenous fistula of the sigmoid sinus: A case report

Somatosound: A review with report of 9 cases with long-term follow-up

Progress in research on intracranial multipleï¿½duralï¿½arteriovenous fistulas (Review)

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