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Updated: Aug 6, 2026
06:17
Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis
Published on: July 11, 2019
Cerebrospinal Fluid-Venous Fistulas: Pathophysiology, Diagnosis, and Management
Emanuele Orru1, Neil V Patel2, Mehran Nasralla3
1Neurointerventional Radiology, Lahey Clinic, Burlington, Massachusetts, USA surgeon.ema@gmail.com.
Journal of Neurointerventional Surgery
|July 16, 2026
Summary
This review offers a framework for diagnosing and managing cerebrospinal fluid-venous fistulas (CVFs), a primary cause of spontaneous intracranial hypotension (SIH). It details diagnostic techniques and treatment options, from conservative measures to surgical and endovascular interventions.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Cerebrospinal fluid-venous fistulas (CVFs) are a significant cause of spontaneous intracranial hypotension (SIH).
- Understanding cerebrospinal fluid (CSF) physiology, including glymphatic pathways, is crucial for comprehending CVF pathogenesis.
- Potential contributing factors include pressure gradients and intracranial hypertension.
Purpose of the Study:
- To establish a practical framework for the understanding, diagnosis, and management of CVFs.
- To review current concepts of CSF physiology and hypotheses regarding CVF etiology.
- To synthesize contemporary literature on diagnostic and therapeutic strategies for CVFs.
Main Methods:
- Review of current literature on CSF physiology, CVF pathophysiology, diagnostic techniques, and management options.
- Detailed description of diagnostic approaches, including lateral decubitus digital subtraction and CT myelography.
- Discussion of various treatment modalities: conservative, epidural blood patching, percutaneous therapies, surgical disconnection, and endovascular treatment.
Main Results:
- A stepwise diagnostic approach is outlined, emphasizing myelographic techniques for CVF localization.
- Comprehensive review of management options, ranging from conservative care to advanced interventional procedures.
- Discussion of endovascular treatment considerations, including anatomy, outcomes, and complications.
Conclusions:
- Effective management of CVFs requires a thorough understanding of CSF dynamics and precise diagnostic localization.
- A spectrum of treatment options exists, tailored to disease severity.
- Further research and standardization are needed in this evolving field.
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