Endovascular treatment of dural fistulas with the venous outflow of laterocavernous sinus.
OBJECTIVE
To report our findings concerning the laterocavernous sinus (LCS) drainage of dural fistulas, focusing our attention on the important implications in treatment of the LCS, which is one of the principal drainage pathways of the superficial middle cerebral vein (SMCV).


METHODS
Consecutive 32 patients with dural fistulas treated endovascularly between 2005 and 2008 were reviewed. Seven patients had angiographic features such as dural fistulas draining with SMCV via LCS. Clinical records for these 7 patients were focused to determine their presenting symptoms, angiographic features, endovascular treatments, and clinical outcomes.


RESULTS
Over 3 years, 7 patients had 7 dural fistulas drained with SMCV via LCS were treated. Six-vessel angiography confirmed the presence of the dural fistulas. All fistulas were Cognard Type III featured by leptomeningeal veins drainage. One fistula involving the lesser sphenoid wing and 6 fistulas involving CS were supplied by external carotid artery branches with or without dural branches of the internal carotid artery. LCS was identified as a contiguous to SMCV drainage in these cases. One patient was treated with transvenous coil embolization alone, two with transvenous a combination of Onyx and coil embolization, and 4 with transarterial embolization. An angiographic obliteration and clinical cure was achieved in all patients. Complication was local hair loss due to X-ray radiation in one patient.


CONCLUSIONS
It is very important to diagnose the presence of LCS in dural fistulas during the diagnostic angiography. It is believed that the knowledge of LCS might be relevant for the understanding and treatment of dural fistulas involving the LCS.
Lv
Xianli
X
Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No 6, Tiantan Xili, Chongwen, Beijing 100050, China.
Jiang
Chuhan
C
Li
Youxiang
Y
Lv
Ming
M
Wu
Zhongxue
Z
D000328:Adult; D002426:Cavernous Sinus; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D055815:Young Adult