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Embryological Consideration of Dural AVF.

Michihiro Tanaka1

  • 1Department of Neurosurgery, Kameda Medical Center, Higashi-cho 929, Kamogawa City, Chiba, 296-8602, Japan. michihiro.tanaka@gmail.com.

Acta Neurochirurgica. Supplement
|September 18, 2016
PubMed
Summary

Intracranial dural arteriovenous fistulas (DAVFs) correlate with skull base bone types. Shunt points predominantly form on endochondral bone, suggesting its histology influences DAVF development.

Keywords:
Dural AVFEmbryological bony structureEndochondral boneMembranous boneSegmental vulnerability of dural membrane

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Area of Science:

  • Neuroscience
  • Radiology
  • Anatomy

Background:

  • Intracranial dural arteriovenous fistulas (DAVFs) are abnormal connections between arteries and veins in the dura mater.
  • The distribution of these fistulas may be influenced by the embryological development of skull base bony structures.

Purpose of the Study:

  • To analyze the distribution of shunt points in intracranial dural arteriovenous fistulas (DAVFs).
  • To investigate the relationship between shunt point localization and the topography of endochondral and membranous bone at the skull base.

Main Methods:

  • Retrospective analysis of 58 consecutive dural arteriovenous fistula (DAVF) cases.
  • Identification of shunt points using digital subtraction angiography, cone beam CT, or 3D rotation angiography.
  • Categorization of shunt points based on their location relative to endochondral bone, membranous bone, or independent structures.

Main Results:

  • Shunt points were identified in 55 of 58 cases.
  • 60% of shunt points (33/55) were located on endochondral bone, associated with sigmoid, carotid cavernous, petrosal apex, and sigmoid DAVFs.
  • 22% (12/55) were on membranous bone (transverse sinus, superior sagittal sinus, confluence DAVFs), and 18% (10/55) were independent (olfactory groove, middle fossa, hypoglossal canal DAVFs).

Conclusions:

  • A correlation exists between dural arteriovenous fistula (DAVF) shunt point localization and the topography of endochondral and membranous bone.
  • Histological differences between endochondral and membranous bone in the epidural space may contribute to the formation of DAVFs.