Treatment of dural arteriovenous malformations and fistulas.
Dural arteriovenous fistulas (DAVFs) or malformations consist of pathological vascular channels located within the substance of the dura mater and usually involve the walls of a dural sinus or adjacent cortical vein. DAVFs can affect a variety of cerebral venous structures and can present at various clinical stages. Although some fistulas can spontaneously thrombose, the clinical course usually involves progression from venous sinus pressurization to occlusion and retrograde cortical venous drainage. The spectrum of clinical presentation ranges from an irritating pulse-synchronous bruit to a disabling neurologic ischemic deficit or life-threatening intracranial hemorrhage from venous hypertension. The authors present their clinical experience in the radiographic diagnosis and endovascular treatment of these potentially dangerous lesions.
Malek
A M
AM
Department of Radiology, Division of Interventional Neurovascular Radiology, University of California San Francisco Medical Center, San Francisco, California, USA. ammalek@ntr.net
Halbach
V V
VV
Higashida
R T
RT
Phatouros
C C
CC
Meyers
P M
PM
Dowd
C F
CF
D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002533:Cerebral Angiography; D004388:Dura Mater / Q000098:blood supply*; D006801:Humans; D014057:Tomography, X-Ray Computed