Dural arteriovenous fistulas draining into the petrosal vein or bridging vein of the medulla: possible homologs of spinal dural arteriovenous fistulas

Clinical article

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  • 1 Service de Neuroradiologie Diagnostique et Therapeutique, Hospital de Bicêtre, Paris, France;
  • 2 Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan;
  • 3 Division of Neurosurgery, Department of Surgery, Siriraj Hospital, Mahidol University; and
  • 4 Department of Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Object

Dural arteriovenous fistulas (DAVFs) with leptomeningeal venous reflux generally pose a high risk of aggressive manifestations including hemorrhage. Among DAVFs, there is a peculiar type that demonstrates direct drainage into the bridging vein rather than the dural venous sinus. The purpose of this study was to investigate the characteristics of DAVFs that drain directly into the petrosal vein or the bridging vein of the medulla oblongata.

Methods

Eleven consecutive cases of DAVFs that drained directly into the petrosal vein and 6 that drained directly into the bridging vein of the medulla were retrospectively reviewed. These cases were evaluated and/or treated at Hospital de Bicêtre in Paris, France, over a 27-year period. A review of previously reported cases was also performed.

Results

Both of these “extrasinusal”-type DAVFs demonstrated very similar characteristics. There was a significant male predominance (p < 0.001) for this lesion, and a significantly higher incidence of aggressive neurological manifestations including hemorrhage or venous hypertension than in DAVFs of the transverse-sigmoid or cavernous sinus (p < 0.001). This finding was considered to be attributable to leptomeningeal venous reflux. Regarding treatment, endovascular embolization (either transarterial or transvenous) is frequently difficult, and surgery may be an effective therapeutic choice in many instances.

Conclusions

Embryologically, both the petrosal vein and the bridging vein of the medulla are cranial homologs of the spinal cord emissary bridging veins that drain the pial venous network. The authors believe that DAVFs in these locations may be included in a single category with spinal DAVFs because of their similar clinical characteristics.

Abbreviations used in this paper: DAVF = dural arteriovenous fistula; ICA = internal carotid artery; MMA = middle meningeal artery; NBCA = N-butyl cyanoacrylate; SAH = subarachnoid hemorrhage; SRS = stereotactic radiosurgery; TAE = transarterial embolization; VA = vertebral artery.

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Contributor Notes

Address correspondence to: Yutaka Mitsuhashi, M.D., Ph.D., Department of Neurosurgery, Osaka City University, Graduate School of Medicine 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan 545-8585. email: y-mitsuhashi@mtf.biglobe.ne.jp.

Please include this information when citing this paper: published online May 8, 2009; DOI: 10.3171/2009.1.JNS08840.

  • 1

    Asakawa H, , Yanaka K, , Fujita K, , Marushima A, , Anno I, & Nose T: Intracranial dural arteriovenous fistula showing diffuse MR enhancement of the spinal cord: case report and review of the literature. Surg Neurol 58:251257, 2002

    • Search Google Scholar
    • Export Citation
  • 2

    Awad IA, , Little JR, , Akarawi WP, & Ahl J: Intracranial dural arteriovenous malformations: factors predisposing to an aggressive neurological course. J Neurosurg 72:839850, 1990

    • Search Google Scholar
    • Export Citation
  • 3

    Borden JA, , Wu JK, & Shucart WA: A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment. J Neurosurg 82:166179, 1995

    • Search Google Scholar
    • Export Citation
  • 4

    Branco G, , Takahashi A, , Ezura M, , Yoshida M, & Yoshimoto T: Dural arteriovenous shunt involving the superior petrosal sinus: presentation and treatment by transvenous embolisation via the occipital and transverse sinuses. Neuroradiology 39:6770, 1997

    • Search Google Scholar
    • Export Citation
  • 5

    Bret P, , Salzmann M, , Bascoulergue Y, & Guyotat J: Dural arteriovenous fistula of the posterior fossa draining into the spinal medullary veins—an unusual cause of myelopathy: case report. Neurosurgery 35:965969, 1994

    • Search Google Scholar
    • Export Citation
  • 6

    Cognard C, , Gobin YP, , Pierot L, , Bailly AL, , Houdart E, & Casasco A, : Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Radiology 194:671680, 1995

    • Search Google Scholar
    • Export Citation
  • 7

    De Jesus O, & Rosado JE: Tentorial dural arteriovenous fistula obliterated using the petrosal approach. Surg Neurol 51:164167, 1999

  • 8

    Deasy NP, , Gholkar AR, , Cox TC, & Jeffree MA: Tentorial dural arteriovenous fistulae: endovascular treatment with transvenous coil embolisation. Neuroradiology 41:308312, 1999

    • Search Google Scholar
    • Export Citation
  • 9

    Deshmukh VR, , Maughan PH, & Spetzler RF: Resolution of hemifacial spasm after surgical obliteration of a tentorial arteriovenous fistula: case report. Neurosurgery 58:E202, 2006

    • Search Google Scholar
    • Export Citation
  • 10

    Djindjian R, , Merland JJ, & Théron J: Super-Selective Arteriography of the External Carotid Artery New York, Springer-Verlag, 1978

  • 11

    Do HM, , Jensen ME, , Cloft HJ, , Kallmes DF, & Dion JE: Dural arteriovenous fistula of the cervical spine presenting with subarachnoid hemorrhage. AJNR Am J Neuroradiol 20:348350, 1999

    • Search Google Scholar
    • Export Citation
  • 12

    Duvernoy HM: Human Brain Stem Vessels: Including the Pineal Gland and Information on Brain Stem Infarction ed 2 Berlin, Springer, 1999. 8293

    • Search Google Scholar
    • Export Citation
  • 13

    Fujita A, , Tamaki N, , Nakamura M, , Yasuo K, & Morikawa M: A tentorial dural arteriovenous fistula successfully treated with interruption of leptomeningeal venous drainage using microvascular Doppler sonography: case report. Surg Neurol 56:5661, 2001

    • Search Google Scholar
    • Export Citation
  • 14

    Gaensler EH, , Jackson DE Jr, & Halbach VV: Arteriovenous fistulas of the cervicomedullary junction as a cause of myelopathy: radiographic findings in two cases. AJNR Am J Neuroradiol 11:518521, 1990

    • Search Google Scholar
    • Export Citation
  • 15

    Geibprasert S, , Pereira V, , Krings T, , Jiarakongmun P, , Toulgoat F, & Pongpech S, : Dural arteriovenous shunts: a new classification of craniospinal epidural venous anatomical bases and clinical correlations. Stroke 39:27832794, 2008

    • Search Google Scholar
    • Export Citation
  • 16

    Grisoli F, , Vincentelli F, , Fuchs S, , Baldini M, , Raybaud C, & Leclercq TA, : Surgical treatment of tentorial arteriovenous malformations draining into the subarachnoid space. Report of four cases. J Neurosurg 60:10591066, 1984

    • Search Google Scholar
    • Export Citation
  • 17

    Hanabusa K, , Morikawa A, , Tashiro H, & Yamanaka M: [Craniocervical junction dural arteriovenous malformation presenting with subarachnoid hemorrhage: report of two cases.]. No Shinkei Geka 27:237241, 1999. (Jpn)

    • Search Google Scholar
    • Export Citation
  • 18

    Hashiguchi A, , Mimata C, , Ichimura H, & Kuratsu J: Occipital neuralgia as a presenting symptom of cervicomedullary dural arteriovenous fistula. Headache 47:10951097, 2007

    • Search Google Scholar
    • Export Citation
  • 19

    Hashimoto H, , Iida J, , Shin Y, , Hironaka Y, & Sakaki T: Spinal dural arteriovenous fistula with perimesencephalic subarachnoid haemorrhage. J Clin Neurosci 7:6466, 2000

    • Search Google Scholar
    • Export Citation
  • 20

    Hurst RW, , Bagley LJ, , Scanlon M, & Flamm ES: Dural arteriovenous fistulas of the craniocervical junction. Skull Base Surg 9:17, 1999

  • 21

    Iwamuro Y, , Nakahara I, , Higashi T, , Iwaasa M, , Watanabe Y, & Hirata E, : Tentorial dural arteriovenous fistula presenting symptoms due to mass effect on the dilated draining vein: case report. Surg Neurol 65:511515, 2006

    • Search Google Scholar
    • Export Citation
  • 22

    Kai Y, , Hamada J, , Morioka M, , Yano S, , Mizuno T, & Kuratsu J: Arteriovenous fistulas at the cervicomedullary junction presenting with subarachnoid hemorrhage: six case reports with special reference to the angiographic pattern of venous drainage. AJNR Am J Neuroradiol 26:19491954, 2005

    • Search Google Scholar
    • Export Citation
  • 23

    Kattner KA, , Roth TC, & Giannotta SL: Cranial base approaches for the surgical treatment of aggressive posterior fossa dural arteriovenous fistulae with leptomeningeal drainage: report of four technical cases. Neurosurgery 50:11561161, 2002

    • Search Google Scholar
    • Export Citation
  • 24

    Kim MS, , Han DH, , Han MH, & Oh CW: Posterior fossa hemorrhage caused by dural arteriovenous fistula: case reports. Surg Neurol 59:512517, 2003

    • Search Google Scholar
    • Export Citation
  • 25

    Kinouchi H, , Mizoi K, , Takahashi A, , Nagamine Y, , Koshu K, & Yoshimoto T: Dural arteriovenous shunts at the craniocervical junction. J Neurosurg 89:755761, 1998

    • Search Google Scholar
    • Export Citation
  • 26

    Koch C, , Gottschalk S, & Giese A: Dural arteriovenous fistula of the lumbar spine presenting with subarachnoid hemorrhage. Case report and review of the literature. J Neurosurg 100:385391, 2004

    • Search Google Scholar
    • Export Citation
  • 27

    Kwon BJ, , Han MH, , Kang HS, & Chang KH: MR imaging findings of intracranial dural arteriovenous fistulas: relations with venous drainage patterns. AJNR Am J Neuroradiol 26:25002507, 2005

    • Search Google Scholar
    • Export Citation
  • 28

    Lasjaunias P, , Chiu M, , ter Brugge K, , Tolia A, , Hurth M, & Bernstein M: Neurological manifestations of intracranial dural arteriovenous malformations. J Neurosurg 64:724730, 1986

    • Search Google Scholar
    • Export Citation
  • 29

    Lasjaunias P, , Geibprasert S, , Pereira V, , Krings T, , Jiarakongmun P, & Aurboonyawat T, : Classification of dural arteriovenous shunts (DAVS) based on the craniospinal epidural venous drainage of the central nervous system and adjacent bony structures. Jpn J Neurosurg (Tokyo) 17:356361, 2008

    • Search Google Scholar
    • Export Citation
  • 30

    Lewis AI, , Tomsick TA, & Tew JM Jr: Management of tentorial dural arteriovenous malformations: transarterial embolization combined with stereotactic radiation or surgery. J Neurosurg 81:851859, 1994

    • Search Google Scholar
    • Export Citation
  • 31

    Mascalchi M, , Scazzeri F, , Prosetti D, , Ferrito G, , Salvi F, & Quilici N: Dural arteriovenous fistula at the craniocervical junction with perimedullary venous drainage. AJNR Am J Neuroradiol 17:11371141, 1996

    • Search Google Scholar
    • Export Citation
  • 32

    Masuo O, , Ozaki F, , Okita R, , Yamaga H, , Maeshima S, & Moriwaki H, : [Dural arteriovenous fistula at the cranio-cervical junction presenting transient ischemic attack: a case report.]. No Shinkei Geka 27:10431046, 1999. (Jpn)

    • Search Google Scholar
    • Export Citation
  • 33

    Matsushige T, , Nakaoka M, , Ohta K, , Yahara K, , Okamoto H, & Kurisu K: Tentorial dural arteriovenous malformation manifesting as trigeminal neuralgia treated by stereotactic radiosurgery: a case report. Surg Neurol 66:519523, 2006

    • Search Google Scholar
    • Export Citation
  • 34

    Matsushima T, , Rhoton AL Jr, , de Oliveira E, & Peace D: Microsurgical anatomy of the veins of the posterior fossa. J Neurosurg 59:63105, 1983

    • Search Google Scholar
    • Export Citation
  • 35

    McDougall CG, , Halbach VV, , Dowd CF, , Higashida RT, , Larsen DW, & Hieshima GB: Dural arteriovenous fistulas of the marginal sinus. AJNR Am J Neuroradiol 18:15651572, 1997

    • Search Google Scholar
    • Export Citation
  • 36

    Nakahara I, , Pile-Spellman J, , Hacein-Bey L, , Crowell RM, & Gress D: [Posterior fossa dural arteriovenous fistula with isolated sinus segment.]. No To Shinkei 45:703709, 1993. (Jpn)

    • Search Google Scholar
    • Export Citation
  • 37

    Ng PP, , Halbach VV, , Quinn R, , Balousek P, , Caragine LP, & Dowd CF, : Endovascular treatment for dural arteriovenous fistulae of the superior petrosal sinus. Neurosurgery 53:2533, 2003

    • Search Google Scholar
    • Export Citation
  • 38

    Nishino A, , Sakurai Y, , Takahashi A, , Satoh H, , Niizuma H, & Kayama T, : [Superior petrosal sinus dural arteriovenous malformation with varix indenting brain stem—report of a case and review of the literature.]. No To Shinkei 43:6269, 1991. (Jpn)

    • Search Google Scholar
    • Export Citation
  • 39

    Oda Y, , Konishi T, , Suzui H, , Fujimoto N, , Nakamura K, & Matsumoto M, : [Partially thrombosed radiculomeningeal arterio-venous fistula in spinomedullary junction.]. No Shinkei Geka 17:6368, 1989. (Jpn)

    • Search Google Scholar
    • Export Citation
  • 40

    Oishi H, , Okuda O, , Arai H, , Maehara T, & Iizuka Y: Successful surgical treatment of a dural arteriovenous fistula at the craniocervical junction with reference to pre- and postoperative MRI. Neuroradiology 41:463467, 1999

    • Search Google Scholar
    • Export Citation
  • 41

    Ott D, , Bien S, & Krasznai L: Embolization of a tentorial dural arterio-venous fistula presenting as atypical trigeminal neuralgia. Headache 33:503508, 1993

    • Search Google Scholar
    • Export Citation
  • 42

    Padget DH: The development of the cranial venous system in man, from the viewpoint of comparative anatomy. Contrib Embryol 36:81140, 1957

    • Search Google Scholar
    • Export Citation
  • 43

    Partington MD, , Rufenacht DA, , Marsh WR, & Piepgras DG: Cranial and sacral dural arteriovenous fistulas as a cause of myelopathy. J Neurosurg 76:615622, 1992

    • Search Google Scholar
    • Export Citation
  • 44

    Piske RL, & Lasjaunias P: Extrasinusal dural arteriovenous malformations. Report of three cases. Neuroradiology 30:426432, 1988

  • 45

    Rahme R, , Ali Y, , Slaba S, & Samaha E: Dural arteriovenous malformation: an unusual cause of trigeminal neuralgia. Acta Neurochir (Wien) 149:937941, 2007

    • Search Google Scholar
    • Export Citation
  • 46

    Reinges MH, , Thron A, , Mull M, , Huffmann BC, & Gilsbach JM: Dural arteriovenous fistulae at the foramen magnum. J Neurol 248:197203, 2001

  • 47

    Rhoton AL Jr: The cerebellopontine angle and posterior fossa cranial nerves by the retrosigmoid approach. Neurosurgery 47:S93S129, 2000

    • Search Google Scholar
    • Export Citation
  • 48

    Ricolfi F, , Manelfe C, , Meder JF, , Arrue P, , Decq P, & Brugieres P, : Intracranial dural arteriovenous fistulae with perimedullary venous drainage. Anatomical, clinical and therapeutic considerations. Neuroradiology 41:803812, 1999

    • Search Google Scholar
    • Export Citation
  • 49

    Rodesch G, , Comoy J, , Hurth M, & Lasjaunias P: Jugular foramen arteriovenous shunt with subarachnoid hemorrhage. Skull Base Surg 1:132136, 1991

    • Search Google Scholar
    • Export Citation
  • 50

    Symon L, , Kuyama H, & Kendall B: Dural arteriovenous malformations of the spine. Clinical features and surgical results in 55 cases. J Neurosurg 60:238247, 1984

    • Search Google Scholar
    • Export Citation
  • 51

    Tanoue S, , Goto K, & Oota S: Endovascular treatment for dural arteriovenous fistula of the anterior condylar vein with unusual venous drainage: report of two cases. AJNR Am J Neuroradiol 26:19551959, 2005

    • Search Google Scholar
    • Export Citation
  • 52

    Thompson BG, , Doppman JL, & Oldfield EH: Treatment of cranial dural arteriovenous fistulae by interruption of leptomeningeal venous drainage. J Neurosurg 80:617623, 1994

    • Search Google Scholar
    • Export Citation
  • 53

    Trop I, , Roy D, , Raymond J, , Roux A, , Bourgouin P, & Lesage J: Craniocervical dural fistula associated with cervical myelopathy: angiographic demonstration of normal venous drainage of the thoracolumbar cord does not rule out diagnosis. AJNR Am J Neuroradiol 19:583586, 1998

    • Search Google Scholar
    • Export Citation
  • 54

    van Dijk JM, , terBrugge KG, , Willinsky RA, & Wallace MC: Clinical course of cranial dural arteriovenous fistulas with long-term persistent cortical venous reflux. Stroke 33:12331236, 2002

    • Search Google Scholar
    • Export Citation
  • 55

    van Rooij WJ, , Sluzewski M, & Beute GN: Tentorial artery embolization in tentorial dural arteriovenous fistulas. Neuroradiology 48:737743, 2006

    • Search Google Scholar
    • Export Citation
  • 56

    Versari PP, , D'Aliberti G, , Talamonti G, , Branca V, , Boccardi E, & Collice M: Progressive myelopathy caused by intracranial dural arteriovenous fistula: report of two cases and review of the literature. Neurosurgery 33:914919, 1993

    • Search Google Scholar
    • Export Citation
  • 57

    Wackenheim A, & Braun JP: The Veins of the Posterior Fossa: Normal and Pathologic Findings Berlin, Springer-Verlag, 1978. 723

  • 58

    Willinsky R, , TerBrugge K, , Lasjaunias P, & Montanera W: The variable presentations of craniocervical and cervical dural arteriovenous malformations. Surg Neurol 34:118123, 1990

    • Search Google Scholar
    • Export Citation
  • 59

    Wrobel CJ, , Oldfield EH, , Di Chiro G, , Tarlov EC, , Baker RA, & Doppman JL: Myelopathy due to intracranial dural arteriovenous fistulas draining intrathecally into spinal medullary veins. Report of three cases. J Neurosurg 69:934939, 1988

    • Search Google Scholar
    • Export Citation
  • 60

    Yamaguchi S, , Oki S, , Mikami T, , Kawamoto Y, , Kuwamoto K, & Saito T: [Myelopathy caused by tentorial dural arteriovenous fistula: a rare case report.]. No Shinkei Geka 28:7378, 2000. (Jpn)

    • Search Google Scholar
    • Export Citation
  • 61

    Yoshida S, , Oda Y, , Kawakami Y, & Sato S: Progressive myelopathy caused by dural arteriovenous fistula at the craniocervical junction—case report. Neurol Med Chir (Tokyo) 39:376379, 1999

    • Search Google Scholar
    • Export Citation

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