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Ischemic stroke in patients with intracranial dural arteriovenous fistulas

Shin-Joe Yeh1, Li-Kai Tsai, Hon-Man Liu

  • 1Department of Neurology, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|May 31, 2011
PubMed

Insights

Intracranial dural arteriovenous fistulas (DAVFs) can lead to ischemic stroke. DAVF location and type, particularly those involving cortical venous drainage, are key factors in stroke occurrence.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Intracranial dural arteriovenous fistulas (DAVFs) are abnormal connections between dura mater arteries and veins.
  • Ischemic stroke is a potential complication of intracranial DAVFs.

Purpose of the Study:

  • To investigate the frequency of ischemic stroke in patients with intracranial DAVFs.
  • To identify determinants associated with the occurrence of ischemic stroke in this patient population.

Main Methods:

  • Retrospective study of 134 consecutive patients diagnosed with intracranial DAVF via cerebral catheter angiography.
  • Exclusion of patients with pure hemorrhagic stroke or inadequate imaging.
  • Ascertainment of DAVF location, Cognard classification, clinical characteristics, and outcomes.

Main Results:

  • Six patients (4.5%) experienced ischemic stroke; the majority were male and presented with seizure or mental decline.
  • Higher risk of ischemic stroke was observed in DAVFs located outside the cavernous or large sinuses and those involving cortical venous drainage (types IIb, III, IV).
  • No ischemic strokes occurred in patients with DAVF types I and IIa. Concomitant cerebral sinus thrombosis increased stroke risk.

Conclusions:

  • DAVF location and type are significant predictors of ischemic stroke.
  • Understanding these factors is crucial for risk stratification and management of patients with intracranial DAVFs.
Abstract

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