title: Bilateral orbital signs predict cortical venous drainage in cavernous sinus dural AVMs.
abstract: BACKGROUND
  Most cavernous sinus dural arteriovenous malformations (CSdAVM) have a benign clinical course. Those CSdAVM that drain into cortical veins have an increased risk for neurologic complications.
  
  
  OBJECTIVE
  To find whether a specific clinical sign predicts cortical venous drainage (CVD) in CSdAVM.
  
  
  METHODS
  The records of 118 patients with CSdAVM were evaluated for the clinical features of the disorder and tested for predictive value of CVD demonstrated angiographically or suggested by MRI using logistic regression and odds ratio (OR) analysis.
  
  
  RESULTS
  Clinical signs that predicted the presence of CVD included bilateral orbital signs (p = 0.004, OR = 23.84) and presence of a postauricular bruit (p = 0.035, OR = 23.8). No other clinical sign predicted the presence of CVD, including extraocular muscle dysfunction, abducens or oculomotor dysfunction, increased intraocular pressure, venous stasis retinopathy, choroidal effusion, optic neuropathy, subjective bruit, and objective orbital bruit.
  
  
  CONCLUSIONS
  Patients who present with or develop bilateral orbital congestion should be recognized as being at increased risk for CVD.
authors.affiliation: Neuro-Ophthalmology Service, Rabin Medical Center, Petah Tikva, Israel. kalisheh@hotmail.com
authors.forename: H
authors.initials: H
authors.lastname: Stiebel-Kalish
authors.forename: A
authors.initials: A
authors.lastname: Setton
authors.forename: A
authors.initials: A
authors.lastname: Berenstein
authors.forename: Y
authors.initials: Y
authors.lastname: Kalish
authors.forename: Y
authors.initials: Y
authors.lastname: Nimii
authors.forename: M J
authors.initials: MJ
authors.lastname: Kupersmith
mesh_terms: D002426:Cavernous Sinus / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology; D002550:Cerebral Veins / Q000473:pathology*; D006801:Humans; D015994:Incidence; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D016017:Odds Ratio; D009916:Orbital Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology