PT  - JOURNAL ARTICLE
AU  - van Rooij, W.J.
AU  - Sluzewski, M.
AU  - Beute, G.N.
TI  - Dural Arteriovenous Fistulas with Cortical Venous Drainage: Incidence, Clinical Presentation, and Treatment
DP  - 2007 Apr 01
TA  - American Journal of Neuroradiology
PG  - 651--655
VI  - 28
IP  - 4
4099  - http://www.ajnr.org/content/28/4/651.short
4100  - http://www.ajnr.org/content/28/4/651.full
SO  - Am. J. Neuroradiol.2007 Apr 01; 28
AB  - BACKGROUND AND PURPOSE: Our purpose was to report our experience with intracranial dural arteriovenous fistulas (DAVFs) with cortical venous drainage during a 12-year period.PATIENTS AND METHODS: Between January 1994 and January 2006, 91 patients with intracranial DAVFs presented at our institution, and 29 (32%) had cortical venous drainage. There were 5 women and 24 men (mean age, 53.9 years; range, 24–77). Clinical presentation was intraparenchymal or subarachnoid hemorrhage in 18 patients (62%), seizures in 4 patients (14%), visual symptoms in 2 patients (7%), pulsatile bruit in 1 patient (3%), and the DAVF (14%) was incidentally discovered in 4 patients.RESULTS: In 2 patients, the DAVF had been obliterated spontaneously at the time of scheduled embolization 10 and 2 months after hemorrhage, respectively. Five patients with an anterior fossa DAVF underwent successful surgery. In 14 patients, the DAVF was completely occluded with embolization alone, and in 7 patients, embolization was followed by surgery. Altogether, complete occlusion was angiographically confirmed in 28 of 29 DAVFs; the result of radiosurgery of 1 DAVF is pending. There were no complications of surgery; embolization was complicated by postembolization hemorrhage in 1 patient (3%).CONCLUSION: Most DAVFs with cortical venous drainage have an aggressive clinical course. Treatment by a neurovascular team by using surgery, embolization, or a combination resulted in cure in all cases, with a very low complication rate.