title: Cerebral perfusion change of venous hypertension on near-infrared spectroscopy signals after operation for dural arteriovenous fistula.
abstract: A dural arteriovenous fistula (AVF) is an arteriovenous shunt in the dura and is associated with a risk of intracranial hemorrhage and neurologic deficit. The morbidity of this disease depends on venous hypertension, and the classification of this disease is based on the pattern of venous drainage. The pattern of venous drainage relates to the clinical features of the disease, especially to the probability of intracranial hemorrhage. We report 1 case of dural AVF with retrograde leptomeningeal venous drainage. Cerebral hemodynamics were monitored using near-infrared spectroscopy imaging before, during, and after the 2-stage operative treatment. Preoperative functional near-infrared spectroscopy (fNIRS) showed an increase in deoxyhemoglobin (HbR) during a motor task. After partial coil embolization of the shunt points (stage 1), HbR increased during the first half of the task and decreased later, whereas oxyhemoglobin (HbO2) decreased in the first half of the task and increased later. After complete embolization (stage 2), fNIRS showed a pattern similar to that of a normal adult. The patient's symptoms improved gradually, and angiography showed a reduction of the retrograde venous drainage and venous congestion after this 2-stage operation. The reduction in venous hypertension may be the underlying mechanism behind the changes observed with fNIRS.
authors: Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan. Electronic address: blsk_sl_satok@z2.keio.jp.
authors: Satoka
authors: S
authors: Shidoh
authors: Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Takenori
authors: T
authors: Akiyama
authors: Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Takayuki
authors: T
authors: Ohira
authors: Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
authors: Kazunari
authors: K
authors: Yoshida
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D015415:Biomarkers / Q000097:blood; D020785:Central Nervous System Vascular Malformations / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D002560:Cerebrovascular Circulation; D004621:Embolization, Therapeutic; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009043:Motor Activity; D009044:Motor Cortex / Q000098:blood supply* / Q000378:metabolism / Q000503:physiopathology; D010108:Oxyhemoglobins / Q000378:metabolism; D011237:Predictive Value of Tests; D019265:Spectroscopy, Near-Infrared; D013997:Time Factors; D016896:Treatment Outcome; D014690:Venous Pressure
chemical_list: D015415:Biomarkers; D010108:Oxyhemoglobins
keywords: Dural arteriovenous fistula; cerebral blood flow; near-infrared spectroscopy