title: Directional intraoperative Doppler ultrasonography during surgery on cranial dural arteriovenous fistulas.
abstract: BACKGROUND
  Directional intraoperative Doppler (dioDoppler) ultrasonography is well established as a tool in the surgery of intracranial aneurysms and cerebral arteriovenous malformations. The literature provides little information about the possible usefulness of this method during surgery on cranial dural arteriovenous fistulas (dAVFs).
  
  
  OBJECTIVE
  To present our experience with the use of dioDoppler during surgery on cranial dAVFs.
  
  
  METHODS
  All patients undergoing craniotomy for cranial dAVF from January 2007 to October 2012 in which dioDoppler was used were included in the study. We reviewed patient records, operating protocols, radiological images, dioDoppler files, and intraoperative videos.
  
  
  RESULTS
  During the study period, 12 patients with cranial dAVFs underwent surgical treatment facilitated by dioDoppler. Four patients were operated on acutely for cerebral bleeds, and 8 patients were treated for various cerebral symptoms and the assumption of a significant risk for intracranial bleed. Three advantages of dioDoppler were unequivocal identification of veins with cortical/deep venous reflux from the fistula, verification of completeness of occlusion of the fistula, and identification of dural arterial feeders not visualized under the microscope.
  
  
  CONCLUSIONS
  Reviewing our experience, we found that dioDoppler sonography is an easy, safe, effective, reliable, and instantaneous tool during surgery on cranial dAVFs.
authors.affiliation: *Department of Neurosurgery, Oslo University Hospital Rikshospitalet, Oslo, Norway; ‡Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Per Kristian
authors.initials: PK
authors.lastname: Eide
authors.forename: Angelika G
authors.initials: AG
authors.lastname: Sorteberg
authors.forename: Torstein R
authors.initials: TR
authors.lastname: Meling
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Sorteberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000601:surgery*; D002550:Cerebral Veins / Q000000981:diagnostic imaging; D003399:Craniotomy / Q000379:methods*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler