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Intraosseous Cranial Dural Arteriovenous Fistula Treated with Transvenous Embolization

Cited 21 time in Web of Science Cited 21 time in Scopus
Authors
Jung, C.; Kwon, B. J.; Kwon, O. -K.; Baik, S. K.; Kim, J. E.; Oh, C. W.; Han, M. H.
Issue Date
2009-07
Publisher
AMER SOC NEURORADIOLOGY
Citation
AMERICAN JOURNAL OF NEURORADIOLOGY; Vol.30 6; 1173-1177
Abstract
BACKGROUND AND PURPOSE: We analyzed the angiographic architecture of intraosseous dural arteriovenous fistulas (DAVFs) and evaluated the use of transvenous embolization for curative treatment. MATERIALS AND METHODS: The study population consisted of 6 patients with intraosseous DAVFs from 3 hospitals. In all of these patients, we retrospectively reviewed the medical records and images, and we were able to confirm the lesions in all patients from CT, MR imaging, and angiographic images. 3D rotational angiographic coronal source images clearly demonstrated the presence of an intraosseous DAVF in 2 patients. RESULTS: An intraosseous DAVF was located at the upper clivus in 1, the petrous apex in 1, and the lower clivus adjacent to the hypoglossal canal in 4 cases. All of the cases showed the presence of a dilated venous pouch, manifest as an osteolytic lesion on CT and as an intraosseous signal-intensity void on MR images. All patients were treated with transvenous embolization by targeting the dilated venous pouch and its connecting tributaries. Four intraosseous DAVFs were immediately completely embolized. One patient had a residual shunt, but the shunt disappeared 1 month later. One patient presented with a simultaneous DAVF in the ipsilateral cavernous sinus without a significant amount of shunt. None of the patients had procedural complications, and 5 patients recovered from the presenting symptoms. CONCLUSIONS: An intraosseous DAVF could be completely cured with transvenous embolization. For curative treatment, the intraosseous dilated venous pouch can be the target lesion for endovascular treatment.
ISSN
0195-6108
Language
English
URI
https://hdl.handle.net/10371/77420
DOI
https://doi.org/10.3174/ajnr.A1528
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College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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