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Edward J. Kosnik, William E. Hunt and Carole A. Miller

pressure; removal of the torcular Herophili created no problem. In accord with the same principle, Poppen and Avman 13 reported division and resection of the vein of Galen and straight sinus in a 16-year-old boy with a vein of Galen malformation. Conclusions Dural arteriovenous malformations are a rare but dangerous lesion. They draw blood primarily from the external carotid circulation and only secondarily from branches of the internal carotid and vertebral systems in their immediate vicinity. Flow problems are created by increased venous pressure more than by

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Shaun P. Appaduray, James A. J. King, Alison Wray, Patrick Lo and Wirginia Maixner

P ediatric dural arteriovenous malformations (dAVMs) are extremely rare, with only 59 cases reported in the literature as of 2010. 10 In a review by Barbosa et al. of 620 cases of intracranial pediatric AVMs reported from 1985 to 2003, only 52 (8.4%) were dAVMs, 1 with the infantile subtype as the most frequent subtype. 7 , 9 , 12 , 15 Pediatric dAVMs tend to be multifocal, with the transverse and sigmoid sinuses the most common sites of involvement. Pediatric dAVMs have a more aggressive clinical course relative to adult dAVMs, with a reported

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Michael W. Nabors, Charles J. Azzam, Faisal J. Albanna, A. Julianna Gulya, David O. Davis and Arthur I. Kobrine

site. The AVM was fed by an enlarged occipital artery and a branch from the middle meningeal artery, and drained rapidly into the sigmoid sinus ( Fig. 1A ). Fig. 1. Case 1. A: Preoperative angiogram demonstrating a dural arteriovenous malformation (AVM) in the posterior fossa at the site of the previous craniectomy. An enlarged occipital artery and posterior middle meningeal branches feed the AVM which drains rapidly into the sigmoid sinus and jugular vein. B: Postembolization angiogram demonstrating marked reduction of the occipital and meningeal feeders

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Akira Kurata, Yoshio Miyasaka, Takatomo Yoshida, Masatake Kunh, Kenzoh Yada and Shinichi Kan

H emorrhage is a well-known and dangerous complication in patients with dural arteriovenous malformations (AVM's), 7, 11, 14, 17, 20 especially in parts of the dura mater unrelated to the sinus. 7, 14 However, venous ischemia 2, 4–6, 9, 10, 13, 15 is not a common complication, and few reports have attempted to evaluate it fully. The criteria of venous ischemia are as follows: 1) angiograms showing venous congestion that can account for the clinical symptoms; 2) other radiological findings demonstrating that the ischemic lesion, mainly affecting the white

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Dural arteriovenous malformations of the spine

Clinical features and surgical results in 55 cases

Lindsay Symon, Hideyuki Kuyama and Brian Kendall

arteriovenous shunt — the basic vascular lesion. An angiographic review of spinal angiomas has shown that many of these lesions have a nidus of abnormal vessels. 5 Spinal dural arteriovenous malformations (AVM's) in which the nidus lies on the dura mater are generally considered uncommon, and most of these have been reported as epidural angiomas associated with intradural or vertebral angiomas in the same patient. 12, 14 In 1977, Kendall and Logue 7 presented 10 cases of spinal dural AVM. Later, Merland, et al. , 11 reported these lesions as “radiculomeningeal

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Ossama Al-Mefty, John R. Jinkins and John L. Fox

: Right common carotid arteriogram, lateral view, after clipping of the internal carotid artery feeders, demonstrating complete obliteration of the dural arteriovenous malformation. At the third operation, temporal craniotomy was performed with clipping of the internal carotid artery feeders behind the petrous pyramid and total excision of the aneurysmal sac contained within the two leaves of the dura mater. Postoperative angiography confirmed complete obliteration of the AVM ( Fig. 4 right ). The route for cerebral venous drainage via the ophthalmic veins

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Naoya Kuwayama, Akira Takaku, Michiharu Nishijima, Shunro Endo and Masato Hirao

alert and had chemosis, proptosis, and exophthalmos of the right eye. Examination revealed an objective bruit around the right orbit and limitation of right ocular movement with a slightly dilated pupil. Her clinical course and the sequential angiographic changes were documented as follows and summarized in Fig. 1 . Fig. 1. Case 1. Sequential changes of angiographical finding. C-dAVM = dural arteriovenous malformation in a cavernous sinus; L-dAVM = dural arteriovenous malformation in a lateral sinus. Admission angiography on April 13 demonstrated a

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James M. Herman, Robert F. Spetzler, Joshua B. Bederson, James M. Kurbat and Joseph M. Zabramski

A lthough numerous theories have been proposed regarding the etiology of dural arteriovenous malformations (AVMs), the pathogenesis of these lesions is still controversial. 1, 2, 4, 12, 14, 15, 18, 19 In 1979 Houser, et al. , 12 proposed that sinus occlusion played a key role in the formation of a dural malformation. He speculated that indigenous dysplastic dural vessels within the sinus develop and establish a direct artery-to-sinus communication during the organization of the intrasinus thrombosis. Awad and colleagues 1, 2 further postulated that sinus

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Saburo Sakaki, Hitoshi Fujita, Kanehisa Kohno and Kenzo Matsuoka

, Fuijiwara M , et al : [ Dural arteriovenous malformations in the region of the transverse-sigmoid sinus. ] Neurol Med Chir 19 : 1203 – 1211 , 1979 (Jpn) Bitoh S, Arita N, Fuijiwara M, et al: [Dural arteriovenous malformations in the region of the transverse-sigmoid sinus.] Neurol Med Chir 19: 1203–1211, 1979 (Jpn) 2. Enker SH : Progression of a dural arteriovenous malformation resulting in an intracerebral hematoma. A case report. Angiology 30 : 198 – 204 , 1979 Enker SH: Progression of a dural

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César P. Lucas, Evandro de Oliveira, Helder Tedeschi, Mario Siqueira, Mario Lourenzi, Ronie L. Piske, Mario Conti and David Peace

state. Postoperative cerebral digital angiogram performed 2 months after surgery showed complete obliteration of the lesion ( Fig. 2D–F ). Fig. 2. Case 2. Dural arteriovenous malformation (AVM) of the tentorial apex. A: Preoperative digital angiogram of the right middle meningeal artery (MMA) (lateral view). The tentorial apex dural AVM is fed mainly by branches of the MMA and superficial temporal artery (STA) through the falx. B: Preoperative digital angiogram of the left occipital artery (OA) (lateral view). The tentorial apex dural AVM is fed by dural