Dural arteriovenous malformations and papilledema.
We examined and managed two patients with posterior fossa dural arteriovenous malformations (DAVMs) and papilledema. Both DAVMs had venous drainage into the transverse, straight, and sigmoid dural venous sinuses. The mechanism of papilledema in the first case was presumed venous hypertension resulting in impaired cerebrospinal fluid absorption, as the malformation drained into the single transverse sinus. This was cured by selective arterial embolization of the causative DAVM. The second patient had venous sinus thrombosis that impaired venous drainage despite embolization. A lumboperitoneal shunt was necessary to treat the elevated intracranial pressure.
Department of Ophthalmology, New York University Medical Center, New York.
M J
MJ
Gelwan
I S
IS
Choi
A
A
Berenstein
J M
JM
Pile-Spellman
M J
MJ
Kupersmith
D002557:Cerebrospinal Fluid Shunts; D003388:Cranial Fossa, Posterior; D004621:Embolization, Therapeutic; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D011859:Radiography