Treatment of dural arteriovenous fistulas presenting as pulsatile tinnitus.
OBJECTIVE
To describe the clinical picture and treatment of dural arteriovenous fistulas (DAVFs) presenting as pulsatile subjective tinnitus.


METHODS
Review of prospectively collected data.


METHODS
Academic referral center.


METHODS
Fourteen patients with clinically and radiographically diagnosed DAVFs.


METHODS
Treated by endovascular route.


METHODS
Treatments, clinical course, complications, and evolution were evaluated.


RESULTS
All patients presented with sleep-disruptive pulsatile tinnitus. Other symptoms included severe headaches, papilledema, proptosis, blepharoptosis, visual disturbances, and hemiparesis. Cortical venous drainage was present in 4 cases. Endovascular treatment was performed at least once by the arterial route in 14 patients and the venous route in 4 patients. The origin of tinnitus was always a vessel in or above the petrous bone. When these arteries or veins could not be visualized in the final control, the tinnitus disappeared. In the patients whose tinnitus returned, a vessel in the petrous bone could always be seen. There was no mortality.


CONCLUSIONS
Endovascular treatment is an effective and safe treatment of DAVFs presenting as tinnitus.
Delgado
Fernando
F
Department of Neuroradiology, Reina Sofía University Hospital, Department of Medicine (Dermatology, Medicine, and Otolaryngology), School of Medicine, University of Cordova, Cordova, Spain. fernando.delgado.sspa@juntadeandalucia.es
Muñoz
Francisco
F
Bravo-Rodríguez
Francisco
F
Jurado-Ramos
Alfredo
A
Oteros
Rafael
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001763:Blepharoptosis / Q000209:etiology / Q000503:physiopathology; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D004621:Embolization, Therapeutic; D005094:Exophthalmos / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006261:Headache / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000209:etiology / Q000503:physiopathology; D010291:Paresis / Q000209:etiology / Q000503:physiopathology; D010579:Petrous Bone / Q000098:blood supply; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000209:etiology / Q000503:physiopathology; D014012:Tinnitus / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome