Cranial Dural Arteriovenous Fistulas: Clinical Findings and Radiologic Diagnostics

摘要: Cranial dural arteriovenous fistulas (DAVFs) are a unique acquired neurovascular entity, which may develop in the dura mater and adjacent pial veins. These shunting lesions of quite distinct from archetypal cerebral malformations because pathologic, pathogenetic, clinicobiological criteria. There remains some confusion debate regarding proper nomenclature, pathophysiology, pathoetiologic mechanisms. Clinical symptoms highly variable depend on specific location lesion, extent arterial supply, especially pattern venous drainage. The Department Neuroradiology, Kantonsspital Aarau, Switzerland, has consecutively assessed 185 patients with cranial DAVFs last 17 years. Treatment consisted observational management, surgical resection, transarterial or transvenous embolization, combination these therapies. A group 95 aggressive (Borden grade 2 3) was analyzed. In regard to their drainage were classified five groups considering both possible pathogenesis. presented hemorrhage, neurologic deficit, seizure, dementia. morphological development seems flow volume recipient. pronounced generation pathologic AV shunts usually takes place at level large sinuses. By contrast, delayed low shunt occurs recipient pressure gradients. Transarterial treatment is chosen improve and/or prevent catastrophic consequences natural history this disease. Once side been occluded, all input (i. e., arterialization) will permanently cease. An anatomic cure can be achieved by obliteration three fashions: occlusion sinus, pouch outside sinus lumen, channel.