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Dural arteriovenous fistulas supplied by ethmoidal arteries
V V Halbach1, R T Higashida, G B Hieshima
1Department of Radiology, University of California, San Francisco Hospital.
Neurosurgery
|May 1, 1990
Summary
Dural arteriovenous fistulas (DAVFs) in the anterior cranial fossa often cause hemorrhage but can also lead to vision loss. Surgical excision effectively treats these DAVFs, leading to a high cure rate.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Ophthalmology
Background:
- Dural arteriovenous fistulas (DAVFs) are abnormal connections between dura mater arteries and veins.
- DAVFs in the anterior cranial fossa are rare and can have varied presentations.
Observation:
- Eight patients with DAVFs on the anterior cranial fossa floor, supplied by ethmoidal arteries, were analyzed.
- Presentations included intracerebral hemorrhage, proptosis, chemosis, elevated intraocular pressure, and vision loss.
Findings:
- Five patients presented with frontal lobe hematomas; two had ocular symptoms due to posterior drainage to the cavernous sinus.
- One patient had two separate DAVFs, and another presented with proptosis and an incidental asymptomatic DAVF.
- Seven patients were cured by surgical excision; one experienced spontaneous obliteration after surgery.
Implications:
- DAVFs of the anterior cranial fossa floor typically manifest as hemorrhage but can also present with ocular symptoms or be asymptomatic.
- Surgical excision of the fistula site is an effective treatment for these challenging vascular malformations.