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[Diagnosis and treatment of tentorial dural arteriovenous fistulae].
Zhonghua Wai Ke Za Zhi. 2005 Mar 01; 43(5):323-6.ZW

Abstract

OBJECTIVE

Tentorial dural arteriovenous fistulae are uncommon but life-threatened lesions. We present our experience of 5 cases with tentorial dural arteriovenous fistulae, review the relevant literature and present the rationale of our current management strategy.

METHODS

The data of five patients with tentorial DAVF treated in Huashan Hospital between June 2002 and May 2003 were reviewed retrospectively, including their ill history, neuroimagings, operation records and follow-up data.

RESULTS

There were 3 females and 2 males with age from 25 to 52 years (average, 42.6 years). Clinical manifestations were acute subarachnoid hemorrhage in 2 cases, progressing neurological deficits in 3 cases. MRI and DSA were major diagnostic and follow-up modalities. Borden classification type II was in 1 case, type III in 4 cases. According to DAVF location, tentorial marginal type were in 3 cases, tentorial lateral type 1 case, tentorial medial type 1 case. Two patients had transarterial embolization preoperatively. All patients underwent craniotomy with the coagulation of the nidus and tentorium, disconnection of leptomeningeal venous drainage. The surgical approaches were via trans-anterior-petrous approach in 3 cases, transpterional subdural approach 1 case, transoccipital and transtentorial approach 1 case. All patients had clinical improvement, there was no surgical mortality and morbidity. Postoperative DSA confirmed obliteration of DAVF in 3 cases, MRI demonstrated the thrombosis of venous aneurysm and the disappearance of previous brainstem edema, partial thrombosis of venous aneurysm in 1 case. Follow-up study ranging from 1 to 2 year showed no recurrence and all patients resume their full activities.

CONCLUSIONS

Tentorial DAVF is an aggressive vascular lesion, causing subarachnoid hemorrhage and progressive neurological deficits. Prompt diagnosis and definite treatment for tentorial DAVF are mandatory. Obliteration of the nidus and/or leptomeningeal venous drainage should be the goal of treatment. Microsurgical procedures with/without endovascular intervention are the best choice of treatment.

Authors+Show Affiliations

Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai Neurosurgical Center, Shanghai 200040, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

15842944

Citation

Zhou, Liang-fu, et al. "[Diagnosis and Treatment of Tentorial Dural Arteriovenous Fistulae]." Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], vol. 43, no. 5, 2005, pp. 323-6.
Zhou LF, Chen L, Song DL, et al. [Diagnosis and treatment of tentorial dural arteriovenous fistulae]. Zhonghua Wai Ke Za Zhi. 2005;43(5):323-6.
Zhou, L. F., Chen, L., Song, D. L., Gu, Y. X., & Leng, B. (2005). [Diagnosis and treatment of tentorial dural arteriovenous fistulae]. Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], 43(5), 323-6.
Zhou LF, et al. [Diagnosis and Treatment of Tentorial Dural Arteriovenous Fistulae]. Zhonghua Wai Ke Za Zhi. 2005 Mar 1;43(5):323-6. PubMed PMID: 15842944.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diagnosis and treatment of tentorial dural arteriovenous fistulae]. AU - Zhou,Liang-fu, AU - Chen,Liang, AU - Song,Dong-lei, AU - Gu,Yu-xiang, AU - Leng,Bing, PY - 2005/4/22/pubmed PY - 2006/11/15/medline PY - 2005/4/22/entrez SP - 323 EP - 6 JF - Zhonghua wai ke za zhi [Chinese journal of surgery] JO - Zhonghua Wai Ke Za Zhi VL - 43 IS - 5 N2 - OBJECTIVE: Tentorial dural arteriovenous fistulae are uncommon but life-threatened lesions. We present our experience of 5 cases with tentorial dural arteriovenous fistulae, review the relevant literature and present the rationale of our current management strategy. METHODS: The data of five patients with tentorial DAVF treated in Huashan Hospital between June 2002 and May 2003 were reviewed retrospectively, including their ill history, neuroimagings, operation records and follow-up data. RESULTS: There were 3 females and 2 males with age from 25 to 52 years (average, 42.6 years). Clinical manifestations were acute subarachnoid hemorrhage in 2 cases, progressing neurological deficits in 3 cases. MRI and DSA were major diagnostic and follow-up modalities. Borden classification type II was in 1 case, type III in 4 cases. According to DAVF location, tentorial marginal type were in 3 cases, tentorial lateral type 1 case, tentorial medial type 1 case. Two patients had transarterial embolization preoperatively. All patients underwent craniotomy with the coagulation of the nidus and tentorium, disconnection of leptomeningeal venous drainage. The surgical approaches were via trans-anterior-petrous approach in 3 cases, transpterional subdural approach 1 case, transoccipital and transtentorial approach 1 case. All patients had clinical improvement, there was no surgical mortality and morbidity. Postoperative DSA confirmed obliteration of DAVF in 3 cases, MRI demonstrated the thrombosis of venous aneurysm and the disappearance of previous brainstem edema, partial thrombosis of venous aneurysm in 1 case. Follow-up study ranging from 1 to 2 year showed no recurrence and all patients resume their full activities. CONCLUSIONS: Tentorial DAVF is an aggressive vascular lesion, causing subarachnoid hemorrhage and progressive neurological deficits. Prompt diagnosis and definite treatment for tentorial DAVF are mandatory. Obliteration of the nidus and/or leptomeningeal venous drainage should be the goal of treatment. Microsurgical procedures with/without endovascular intervention are the best choice of treatment. SN - 0529-5815 UR - https://www.unboundmedicine.com/medline/citation/15842944/[Diagnosis_and_treatment_of_tentorial_dural_arteriovenous_fistulae]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0529-5815&year=2005&vol=43&issue=5&fpage=323 DB - PRIME DP - Unbound Medicine ER -