Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb

Tirakotai, Wuttipong; Benes, Ludwig; Kappus, Christoph; Sure, Ulrich; Farhoud, Ahmed; Bien, Siegfried; Bertalanffy, Helmut

doi:10.1007/s10143-006-0056-2

Cited by 23 publications

(17 citation statements)

References 30 publications

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“…The risk is high especially when the embolization was performed in the ascending pharyngeal artery. Tirakotai et al reported four cases of intraosseous DAVF involving the jugular bulb treated successfully by surgical resection after failed endovascular treatment 23 . one of the patients needed occipitocervical fixation due to resection of bilateral lesions.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment and Computed Imaging Follow-up of 14 Anterior Condylar Dural Arteriovenous Fistulas

et al. 2014

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We report our experience in treating the anterior condylar dural arteriovenous fistula (DAVF) and confirm the location of the coils in the follow-up images after successful endovascular treatment. We retrospectively reviewed the 14 patients with anterior condylar DAVF treated successfully in our institute. Twelve of them had CT or MR follow-up images. All the patients had intravascular coiling of the fistula. Seven of our patients had retrograde drainage to different sinuses. Three had ocular symptoms as a clinical manifestation. We treated nine patients with coils alone (eight transvenous, one transarterial), four with adjuvant transarterial treatment with particles or liquid embolic for minimal residual after coiling packing. One patient had failed onyx treatment and successful treatment by following transvenous packing. All patients had total obliteration of the DAVF fistula on immediate post-procedure angiogram or on the follow-up images and no evidence of recurrence clinically. The mean follow-up period was 34.2 months (standard deviation=39.8). Twelve patients had computed images (CT alone in four, MR alone in five, both CT and MR in three). These findings were analyzed by four certified neuroradiologists. We found 100% of the coils at the anterior condylar veins inside the hypoglossal canal, 54.2% at the lateral lower clivus, and only 14.2% at the anterior condylar confluence which is ventrolateral to the anterior orifice of the hypoglossal canal. Intravascular coiling is the treatment of choice in patients with anterior condylar DAVF. All the coils were found at the anterior condylar veins inside the hypoglossal canal after successful treatment.

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Section: Discussionmentioning

confidence: 99%

Endovascular Treatment and Computed Imaging Follow-up of 14 Anterior Condylar Dural Arteriovenous Fistulas

et al. 2014

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“…Any change, including improvement in the ophthalmologic symptoms, may signify changes in the fistula and requires prompt investigation. Considering the complexity of open surgical approaches to the region, with potential morbidity and significant blood loss, 19,21,23 treatment should always include careful evaluation of endovascular options. Different endovascular approaches are described and treatment should be tailored to specific characteristics of each case, since size and accessibility of vascular supply and drainage may vary from case to case.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Therapy of Hypoglossal Canal AVFs Presenting with Orbital Symptoms

Miropolsky

Costa²,

Marotta³

et al. 2009

Can. j. neurol. sci.

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Dural arteriovenous fistulae (DAVF) are abnormal arteriovenous shunts that occur in the dura. Clinical manifestation is related to the pattern of venous drainage and can include ocular symptoms, bruit, congestive venous encephalopathy and intracranial hemorrhage. Approximately 50% of dural arteriovenous fistulae occur in the posterior fossa, and typically involve the transverse and sigmoid sinuses. Involvement of the tentorium or marginal sinus is less common. Borden et al have classified cranial DAVF as follows: Type I DAVFs are those that drain directly into the dural venous sinus or meningeal vein. Type II DAVFs are those that drain into the venous sinus with retrograde drainage into subarachnoid (superficial) veins. Type III DAVFs are those that drain into the ABSTRACT: Objective: Dural arteriovenous fistulae (DAVF) of the hypoglossal canal region are rare lesions. We describe three cases of DAVF of the hypoglossal canal presenting with ocular symptoms and discuss the endovascular management options. Methods: Three consecutive patients with DAVF of the hypoglossal canal region presented with proptosis, chemosis and disturbances of extra-ocular mobility. Each patient was treated using a different endovascular approach, based on variations of the vascular access. Results: The cases and treatments are reviewed, with a literature review on the subject. Endovascular treatment, transvenous or trans-arterial was curative in all cases. Conclusion: DAVF of the hypoglossal canal region can present with ocular manifestations very similar to DAVF of the cavernous sinus or carotid-cavernous fistulas. Endovascular treatment is usually feasible and effective, but an understanding of the vascular anatomy and pathophysiology of the disease are of utmost importance when planning the approach.RÉSUMÉ: Traitement endovasculaire des fistules artérioveineuses du canal de l'hypoglosse avec symptômes orbitaires. Objectif : Les fistules artérioveineuses durales (FAVD) de la région du canal de l'hypoglosse sont rares. Nous décrivons trois cas de FAVD du canal de l'hypoglosse dont les symptômes initiaux étaient des symptômes oculaires et nous discutons des options endovasculaires de traitement. Méthodes : Trois patients consécutifs atteints de FAVD de la région du canal de l'hypoglosse ont consulté pour exophtalmie, chémosis et troubles de la motricité extra-oculaire. Chaque patient a été traité au moyen d'une approche endovasculaire différente à cause de variations individuelles de l'accès vasculaire. Résultats : Les cas et les traitements ont été révisés et nous avons procédé à une revue de littérature sur ce sujet. Le traitement endovasculaire, transveineux ou transartériel, s'est avéré curatif dans tous les cas. Conclusion : Les FAVD de la région du canal de l'hypoglosse peuvent provoquer des manifestations oculaires comme symptômes initiaux qui sont très semblables à celles des FAVD du sinus caverneux ou des fistules carotidiennes-caverneuses. Le traitement endovasculaire est habituellement faisable et efficace, mais une compréhen...

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“…that is affected by DAVFs is fundamentally important. Although the association of osseous venous structures with AC-AVFs has been reported frequently, 3,8,9,11,[13][14][15][16][17]19) the osseous venous structures adjacent to the hypoglossal canal were studied rarely [20][21][22][23] before we recently investigated them using CT digital subtraction venography. 18) The bone surrounding the hypoglossal canal contains many venous structures ( Figs.…”

Section: Department Of Neurosurgery Keio University School Of Medicimentioning

confidence: 99%

“…Based on our investigation, the AC-AVF seemed to be considered as a group of fistulas adjacent to the lateral parts (exoccipital) of the occipital bone, which includes the hypoglossal canal, jugular tubercle, occipital condyle, and the jugular process. Although the involvement of the osseous structures has been frequently reported previously, 3,8,9,11,[13][14][15][16][17]19) the anterior condylar vein has been traditionally considered as a location of a fistulous pouch in AC-AVF. Without modern CT digital subtraction venography or cone beam CT, it is difficult to recognize these intraosseous venous structures and to distinguish between the two fistulous locations: the anterior condylar vein and JTVC.…”

Section: Angioarchitecture Of the Anterior Condylar Avfmentioning

confidence: 99%

“…12) Other authors also reported DAVFs located within the bone adjacent to the hypoglossal canal. [13][14][15][16][17] These multiple locations have been assumed as fistulous locations, and accordingly, a comprehensive analysis of the shunt location is necessary to understand the pathophysiology of AC-AVFs and to facilitate effective and safe treatment. Recently, we reported that the AC-AVF is a group of fistula that develops in emissary and osseous veins adjacent to the hypoglossal canal.…”

Section: Introductionmentioning

confidence: 99%

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The Anterior Condylar Arteriovenous Fistula from the Viewpoint of the Osseous Venous Anatomy

Mizutani

Akiyama

Yoshida

2019

JNET

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The anterior condylar arteriovenous fistula (AC-AVF) is a relatively rare AVF that affects the vasculatures adjacent to the hypoglossal canal. We aimed to discuss the etiology and definition of the AC-AVF from the viewpoint of the osseous venous anatomy. Our recent study, which used modern imaging technology (CT digital subtraction venography and cone beam CT reconstructed from 3D rotational angiography), elucidated the intraosseous venous anatomy in this region and the precise fistulous locations of AC-AVFs. Those findings suggest that the AC-AVF is a group of "osseous" AVF that involves the anterior condylar vein and jugular tubercle venous complex (JTVC), and the osseous veins connected to them. The AC-AVF develops in osseous veins adjacent to the hypoglossal canal, and it is one of the most common subtypes of osseous AVFs. The angioarchitectures and etiology of AC-AVFs discussed herein are essential to understand this clinical entity.

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Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb

Cited by 23 publications

References 30 publications

Endovascular Treatment and Computed Imaging Follow-up of 14 Anterior Condylar Dural Arteriovenous Fistulas

Endovascular Treatment and Computed Imaging Follow-up of 14 Anterior Condylar Dural Arteriovenous Fistulas

Endovascular Therapy of Hypoglossal Canal AVFs Presenting with Orbital Symptoms

The Anterior Condylar Arteriovenous Fistula from the Viewpoint of the Osseous Venous Anatomy

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