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[Transvenous embolization for cavernous dural arteriovenous shunts: about the intracranial venous approach to the cavernous sinus].
No Shinkei Geka. 2000 Jul; 28(7):639-45.NS

Abstract

Recently, the first choice of therapy for cavernous dural arteriovenous shunts (CdAVS) is transvenous embolization. Usually the approach routes for cavernous sinus are the inferior petrosal sinus (IPS), the superior ophthalmic vein (SOV) in most cases and the superior petrosal sinus (SPS) in rare case. But, it is difficult for us to treat patients in whom there are no extracranial veins through which to approach the cavernous sinus, with transvenous embolization. We presented the case in which intracranial transvenous approach to the cavernous sinus and transvenous embolization were performed and in which we achieve good results. In this article, we presented a case with Barrow's type D CdAVS and cortical venous drainage. At first, transarterial embolization was performed to decrease the amount of venous drainage for the purpose of eliminate convulsions and consciousness disturbance. However, cortical venous drainage continued. Moreover bilateral dilated SOVs normalized and bilateral IPSs were not visible, so we decided that it was impossible to carry out the transvenous embolization via extracranial veins. Transvenous embolization to the left cavernous sinus via the intracranial ophthalmic vein between the superior ophthalmic fissure and the inferior ophthalmic fissure after craniotomy was performed. Then, the transvenous embolization to the right cavernous sinus was carried out through the right superficial middle cerebral vein after craniotomy. The results were good and chemosis and bilateral abducens palsy diminished immediately. Trans-intracranial venous embolization for CdVAS is a very useful therapy when no extracranial veins exist for transvenous embolization.

Authors+Show Affiliations

Department of Neurosurgery, Kagawa Rosai Hospital, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

10920826

Citation

Yoshino, K, et al. "[Transvenous Embolization for Cavernous Dural Arteriovenous Shunts: About the Intracranial Venous Approach to the Cavernous Sinus]." No Shinkei Geka. Neurological Surgery, vol. 28, no. 7, 2000, pp. 639-45.
Yoshino K, Yasuhara T, Kusaka N, et al. [Transvenous embolization for cavernous dural arteriovenous shunts: about the intracranial venous approach to the cavernous sinus]. No Shinkei Geka. 2000;28(7):639-45.
Yoshino, K., Yasuhara, T., Kusaka, N., Nakagawa, M., Terai, Y., & Fujimoto, S. (2000). [Transvenous embolization for cavernous dural arteriovenous shunts: about the intracranial venous approach to the cavernous sinus]. No Shinkei Geka. Neurological Surgery, 28(7), 639-45.
Yoshino K, et al. [Transvenous Embolization for Cavernous Dural Arteriovenous Shunts: About the Intracranial Venous Approach to the Cavernous Sinus]. No Shinkei Geka. 2000;28(7):639-45. PubMed PMID: 10920826.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Transvenous embolization for cavernous dural arteriovenous shunts: about the intracranial venous approach to the cavernous sinus]. AU - Yoshino,K, AU - Yasuhara,T, AU - Kusaka,N, AU - Nakagawa,M, AU - Terai,Y, AU - Fujimoto,S, PY - 2000/8/2/pubmed PY - 2001/2/28/medline PY - 2000/8/2/entrez SP - 639 EP - 45 JF - No shinkei geka. Neurological surgery JO - No Shinkei Geka VL - 28 IS - 7 N2 - Recently, the first choice of therapy for cavernous dural arteriovenous shunts (CdAVS) is transvenous embolization. Usually the approach routes for cavernous sinus are the inferior petrosal sinus (IPS), the superior ophthalmic vein (SOV) in most cases and the superior petrosal sinus (SPS) in rare case. But, it is difficult for us to treat patients in whom there are no extracranial veins through which to approach the cavernous sinus, with transvenous embolization. We presented the case in which intracranial transvenous approach to the cavernous sinus and transvenous embolization were performed and in which we achieve good results. In this article, we presented a case with Barrow's type D CdAVS and cortical venous drainage. At first, transarterial embolization was performed to decrease the amount of venous drainage for the purpose of eliminate convulsions and consciousness disturbance. However, cortical venous drainage continued. Moreover bilateral dilated SOVs normalized and bilateral IPSs were not visible, so we decided that it was impossible to carry out the transvenous embolization via extracranial veins. Transvenous embolization to the left cavernous sinus via the intracranial ophthalmic vein between the superior ophthalmic fissure and the inferior ophthalmic fissure after craniotomy was performed. Then, the transvenous embolization to the right cavernous sinus was carried out through the right superficial middle cerebral vein after craniotomy. The results were good and chemosis and bilateral abducens palsy diminished immediately. Trans-intracranial venous embolization for CdVAS is a very useful therapy when no extracranial veins exist for transvenous embolization. SN - 0301-2603 UR - https://www.unboundmedicine.com/medline/citation/10920826/[Transvenous_embolization_for_cavernous_dural_arteriovenous_shunts:_about_the_intracranial_venous_approach_to_the_cavernous_sinus]_ DB - PRIME DP - Unbound Medicine ER -