Purpose
Superior sagittal sinus dural arteriovenous fistulas (SSS-DAVFs) are relatively rare vascular lesions which represent approximately 4.6-14% of intracranial DAVFs (1-2,4).
Partial or complete occlusion of the SSS is a highly associated condition,
and may be the precursor to the development of the SSS-DAVF (2). Borden Type-3 DAVFs drain retrogradely into cortical veins.
Therefore,
Borden Type-3 SSS-DAVFs are frequently associated with aggressive neurologic symptoms including cerebral hemorrhage,
conscious disturbance,
and dementia.
Although SSS-DAVFs have been treated by several techniques,
including open surgery,
transvenous embolization,
transarterial embolization...
Methods and Materials
We retrospectively reviewed 6 consecutive patients with Borden type-3 SSS-DAVFs treated in our institutions between September 2002 and September 2012.
The clinical findings of the six patients are summarized in Table 1.
There were 3 males and 3 females,
with ages ranging from 71 to 86 years (mean age,
78.0).
Symptoms were headache (n=1),
cognitive disorder (n=2),
disturbance of consciousness (n=1),
hemiparalysis (n=1),
and cerebral hemorrhage (n=2).
Two patients had no symptoms.
One patient had a history of clipping for an anterior communicating artery aneurysm,...
Results
Angiographic features.
Angiographic features of the six patients are summarized in Table 2.
The paramedian branches of the middle meningeal artery and the frontal and parietal branches of the superficial temporal artery supplied the SSS-DAVF bilaterally in all patients.
The anterior falx arteries,
which originate from the ophthalmic artery,
supplied the SSS-DAVF in 4 patients,
and the transosseous branches of the occipital artery supplied the SSS-DAVF in 2 patients.
Shunted pouches were found in all 6 patients,
which were located superolaterally or superomedially to the...
Conclusion
Halbach(2) et al.
reported that SSS-DAVFs are relatively rare (11 % in their series),
and are highly associated with head trauma and sinus thrombosis.
Thrombus formation due to several causes such as operation and trauma can cause proliferation of vessels at the venous sinus wall and arteriovenous shunts.
However,
sinus thrombosis was observed less frequently in histopathologic examinations(5).
A histopathologic study by Nishijima et al.(6) showed that arteriovenous fistulas were located in the dural sinus wall and/or the adjacent dura mater.
Restrictive changes in the...
References
1.Kuwayama N,
et al:Present Status in the Treatment of Dural Arteriovenous Fistulas in Japan:Jpn J Neurosurg 20:12-19,
2011.
2.Halbach VV,
et al: Treatment of dural arteriovenous malformations involving the superior saggital sinus.
Am J Neuroradiol 9:337-343,
1988.
3.Shimizu S,
et al: Sinus thrombosis probably resulting from a dural arteriovenous fistula development in the superior saggital sinus: Acta Neurochir 145:719-721,
2003
4.Bavinzski G,
et al: Variant Arteriovenous Fistula of the Supeior Sagittal Sinus: Neurol Med Chir 39:362-366,
1999.
5.Hamada Y,
Goto K,
Inoue T,
et al....
Personal Information
Takeaki Dotsu MD,
Department of Radiology,
NAGATOMI NOH-SHINKEIGEKA BYOIN,
Oita ,Japan;
[email protected]