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Risk factors for hemorrhagic presentation in patients with dural arteriovenous fistulae

Vineeta Singh1, W S Smith, Michael T Lawton

  • 1Department of Neurology, University of California at San Francisco, San Francisco, CA 94143, USA. vineeta.singh@ucsfmedctr.org

Neurosurgery
|April 22, 2008
PubMed

Insights

Intracranial dural arteriovenous fistulae (DAVFs) are more likely to cause hemorrhage in men. Factors like cortical venous drainage, posterior fossa location, older age, and neurological deficits independently increase hemorrhage risk in DAVF patients.

Area of Science:

  • Neurology
  • Neurosurgery
  • Vascular Neurology

Background:

  • Intracranial dural arteriovenous fistulae (DAVFs) can lead to severe intracranial hemorrhage.
  • Understanding risk factors for hemorrhagic presentation is crucial for patient management.

Purpose of the Study:

  • To identify independent demographic and clinical predictors of hemorrhagic presentation in patients with intracranial dural arteriovenous fistulae.

Main Methods:

  • Retrospective review of 402 patients with DAVFs evaluated between July 1988 and June 2004.
  • Analysis of clinical and radiographic characteristics to determine associations with intracranial hemorrhage.

Main Results:

  • 18% of patients presented with intracranial hemorrhage.
  • Male sex, cortical venous drainage, retrograde venous drainage, and sinus occlusion were more common in patients with hemorrhage.
  • Multivariate analysis identified cortical venous drainage, focal neurological deficits, posterior fossa DAVFs, male sex, and age >50 years as independent predictors of hemorrhage.

Conclusions:

  • Male sex, while less common for DAVFs, is associated with a higher likelihood of hemorrhage.
  • Cortical venous drainage, posterior fossa location, older age, and focal neurological deficits are independently associated with increased risk of intracranial hemorrhage in DAVF patients.
Abstract

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