Treatment of Superior Sagittal Sinus Dural Arteriovenous Fistula.
- Author:
Tae Yeon KIM
1
;
Hyung Jin LEE
;
Jin Seok YI
;
Ji Ho YANG
;
Il Woo LEE
Author Information
1. Department of Neurosurgery, Daejon St. Mary's Hospital, The Catholic University of Korea, Daejon, Korea. kope95@hanmail.net
- Publication Type:Original Article
- Keywords:
Superior sagittal sinus;
Dural arteriovenous fistula;
Intraoperative Doppler
- MeSH:
Aneurysm;
Central Nervous System Vascular Malformations*;
Drainage;
Fistula;
Follow-Up Studies;
Humans;
Superior Sagittal Sinus*
- From:Korean Journal of Cerebrovascular Surgery
2007;9(2):143-147
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Dural arteriovenous fistulas (dAVFs) at the superior sagittal sinus (SSS) are very rare. Endovascular treatment alone often fails to eliminate the fistula because of the midline location of the SSS, the eloquent venous drainage and the multiple bilateral arterial feeders. Surgical extirpation of dAVFs is not recommended in all cases because of the considerable risks involved. We report here on a case of dAVF at the SSS with patent sinus drainage and retrograde leptomeningeal venous drainage, and this was selectively disconnected using an aneurysmal clip under intraoperative Doppler monitoring. The neurological symptoms vanished during the 2 years of follow-up, and no further progression of the dAVF has been found. The methods of converting aggressive dAVFs to benign forms are relatively safe and simple. Therefore, this simple and effective method could be recommended for older aged patients with high intraoperative risk.
