title: Diploic arteriovenous fistulas--classification and endovascular management.
abstract: BACKGROUND
  The authors report on two cases of diploic arteriovenous fistulas (AVFs) in the left parieto-occipital region of a 20-year-old female and the right parietal region of a 68-year-old male. The clinical presentation, angiographic appearance, and endovascular management of these rare lesions are discussed.
  
  
  METHODS
  Retrospective data from two patients with diplopic AVFs are examined with a review of all published cases of diploic arteriovenous fistulas.
  
  
  RESULTS
  Where previously reported diploic AVFs showed venous drainage to be intracranial or combined, two case studies examined by the authors found exclusively extracranial drainage in the AVFs. In both case studies the lesions were primarily fed by the middle meningeal artery and treated via a transarterial endovascular approach using n-BCA glue.
  
  
  CONCLUSIONS
  After reviewing all reported cases of AVF in the literature and combining our two new observations, we concluded that diploic AVFs can have three types of venous outflow: draining toward dural sinuses only, toward extracranial veins only, and combining the dural and extracranial pathways.
authors.affiliation: Department of Neurology, Anesthesiology & Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA, Lriver14@jhmi.edu.
authors.forename: Lucia
authors.initials: L
authors.lastname: Rivera-Lara
authors.forename: Philippe
authors.initials: P
authors.lastname: Gailloud
authors.forename: Paul
authors.initials: P
authors.lastname: Nyquist
mesh_terms: D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D003392:Cranial Sinuses / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008576:Meningeal Arteries / Q000473:pathology / Q000601:surgery