Sphenoid Wing Dural Arteriovenous Fistulas.

Area of Science:

• Neurology
• Vascular Surgery
• Radiology

Background:

• Sphenoid wing dural arteriovenous fistulas (DAVFs) are uncommon vascular malformations.
• They can manifest as non-sinus arteriovenous fistulas (AVFs) with neurological deficits, venous hypertension, or hemorrhage.
• These lesions are categorized as lesser or greater sphenoid wing types.

Purpose of the Study:

• To review and discuss the angioarchitecture, clinical presentation, and treatment of sphenoid wing DAVFs.
• To clarify the characteristics of these rare lesions based on existing literature.

Main Methods:

• A systematic search of PubMed was conducted for studies on sphenoid wing DAVFs.
• 37 cases from 22 papers were analyzed, focusing on clinical presentation, surgical, and endovascular treatments.
• Angioarchitecture and venous drainage patterns were examined.

Main Results:

• 17 cases of lesser sphenoid wing AVFs showed shunts in the sinus of the lesser sphenoid wing (SLSW) or superficial middle cerebral vein (SMCV).
• 20 cases of greater sphenoid wing AVFs exhibited varied shunt localizations and venous return patterns, often with cortical venous reflux.
• Common treatments included surgical ligation and embolization, with embolization emerging as the standard.

Conclusions:

• Sphenoid wing DAVFs present diverse angioarchitectural features and clinical manifestations.
• Understanding these variations is crucial for effective treatment planning.
• Endovascular embolization is the current standard of care for these complex lesions.