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Dural arteriovenous fistula
A dural arteriovenous fistula, also called a dural arteriovenous malformation, is an abnormal direct connection (fistula) between a meningeal artery and a meningeal vein or dural venous sinus. Additional recommended knowledge
ClassificationThe Borden Classification of Dural arteriovenous malformations or fistulas, groups into three types based upon their venous drainage:[1]
Type IType I dural arteriovenous fistulas are suppied by meningeal arteries and drain into a meningeal vein or dural venous sinus. The flow within the draining vein or venous sinus is anterograde.
The distinction between Types Ia and Ib is somewhat specious as there is a rich system of meningeal arterial collaterals. Type I dural fistulas are often asymptomatic, do not have a high risk of bleeding and do not necessarily need to be treated. Type IIThe high pressure within a Type II dural AV fistula causes blood to flow in a retrograde fashion into subarachnoid veins which normally drain into the sinus. Typically this is because the sinus has outflow obstruction. Such draining veins form venous varices or aneuryms which can bleed. Type II fistulas need to be treated to prevent hemorrhage. The treatment may involve embolization of the draining sinus as well as clipping or embolization of the draining veins. Type IIIType III dural AV fistulas drain directly into subarachnoid veins.[2] These veins can form aneurysms and bleed. Type III dural fistulas need to be treated to prevent hemorrhage. Treatment can be as simple as clipping the draining vein at the site of the dural sinus. If treatment involves embolization, it will only typically be effective if the glue traverses the actual fistula and enters, at least slightly, the draining vein. TreatmentOne approach used for treatment is embolization.[3] See also
References
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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Dural_arteriovenous_fistula". A list of authors is available in Wikipedia. |