Childhood dural arteriovenous fistulae of the posterior dural sinuses: three case reports and literature review.
We report three cases of posterior dural sinus arteriovenous fistulae in pediatric patients and a literature review of 18 additional cases. These lesions carry a grave prognosis with a reported mortality of 38% and with an historical anatomic cure of only approximately 9%. With advanced neurointerventional techniques and increased knowledge of their pathophysiology, these highly complicated lesions can be more safely treated with a strategy that involves extensive preoperative embolization and surgical excision. The importance of delaying direct surgery with conservative measures or interventional radiological treatment, including preoperative transarterial and transvenous embolization, is critical in the management of these lesions.
Morita
A
A
Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Meyer
F B
FB
Nichols
D A
DA
Patterson
M C
MC
D002533:Cerebral Angiography; D002648:Child; D003131:Combined Modality Therapy; D003392:Cranial Sinuses / Q000000981:diagnostic imaging / Q000601:surgery*; D003399:Craniotomy; D004388:Dura Mater / Q000098:blood supply*; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000000981:diagnostic imaging