PMID: 2494859Mar 1, 1989Paper

Treatment of dural fistulas involving the deep cerebral venous system.

AJNR. American Journal of Neuroradiology
V V HalbachE Kwan

Abstract

Eight patients with dural arteriovenous fistulas involving the deep cerebral venous system were treated by a combination of preoperative embolization, intraoperative embolization, and/or surgical excision. All eight patients were men 30-71 years old (mean age, 48.5). The presenting symptoms were hemorrhage in four patients (two subarachnoid, one intraventricular, and one parenchymal), stroke in two patients, and severe chronic headaches in two patients. Four patients were treated and cured by preoperative embolization of external carotid feeding vessels followed by direct intraoperative placement of liquid adhesives into the fistula site. Two patients underwent preoperative embolization followed by surgical interruption of feeding vessels to the fistula. Both patients had persistent fistulas and were subsequently treated by intraoperative embolization with liquid adhesives. One patient was cured and the second had 95% reduction in fistula size. The remaining two patients had surgical excision of the fistula, one in combination with preoperative embolization. Both were completely cured. Two patients developed hydrocephalus after placement of liquid adhesive into the involved vein of Galen and were successfully treated with place...Continue Reading

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