title: Lumbar peritoneal shunt containing a programmable valve for intracranial hypertension caused by Borden type 1 dural arteriovenous fistulas.
abstract: Three male patients underwent lumbar peritoneal (LP) shunt for intracranial hypertension caused by intracranial Borden type 1 dural arteriovenous fistulas (D-AVFs). Endovascular treatment was performed initially, but it was ineffective in all cases. Before LP shunt, the Mariotte blind spot expanded in all cases and severe papilledema was observed in two cases. We managed the opening pressure of the shunt system in accordance with patient symptoms. Mariotte blind spot expansion and papilledema disappeared after LP shunt. Follow-up cerebral angiography revealed spontaneous closure of D-AVFs in one case and aggressive conversion in two cases. D-AVFs were completely closed by transvenous embolization. Because the angioarchitecture of the fistula frequently worsens without deterioration of the symptom after LP shunt, follow-up angiography and additional treatment are important.
authors: Department of Neurosurgery, Nagoya City University Medical School, Mizuho-cho, Mizuho-ku, Japan. aihara@med.nagoya-cu.ac.jp
authors: Noritaka
authors: N
authors: Aihara
authors: Mitsuhito
authors: M
authors: Mase
authors: Yusuke
authors: Y
authors: Nishikawa
authors: Takayuki
authors: T
authors: Ohno
authors: Kazuo
authors: K
authors: Yamada
mesh_terms: D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D019586:Intracranial Hypertension / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*; D008161:Lumbosacral Region / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010536:Peritoneovenous Shunt / Q000379:methods*; D013525:Surgical Instruments / Q000592:standards*; D014656:Vascular Surgical Procedures / Q000379:methods