Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0041-1731594
Dural Arteriovenous Fistula within Superior Sagittal Sinus Wall with Direct Cortical Venous Drainage: A Systematic Literature Review
![](https://www.thieme-connect.de/media/10.1055-s-00033348/202202/lookinside/thumbnails/10-1055-s-0041-1731594_2100011-1.jpg)
Abstract
Dural arteriovenous fistulas (DAVFs) located within superior sagittal sinus (SSS) wall with direct cortical venous drainage are rare. They are also known as variant DAVF (vDAVF) and form a special subgroup of DAVFs. Their chance of presenting with aggressive features is high compared with transverse sigmoid sinus fistula. They drain directly into cortical veins (Borden type 3, Cognard type III and IV). A systematic English literature review of SSS vDAVF was made. Systematic literature review revealed a total of 31 published cases. These were commonly seen in male population, (24 males, 77.41%, 24/31). Average age of patients was 54 years. A total of 24 patients (77.41%, 24/31) had aggressive clinical presentations with 13 patients (41.93%, 13/31) having intracranial hemorrhages (ICH). Two patients had rebleeding (15.38%, 2/13). Middle portion of SSS was commonly involved (15 cases, 75%). A total of 25 (96.15%, 25/26) cases had patent SSS. Most of the fistulas were idiopathic (65.38%, 17/26), with trauma being a frequent etiological factor (26.92%, 7/26). Venous ectasia was seen in 19 patients (59.37%, 19/32). Middle meningeal arterial (MMA) supply was seen in all patients (100%, 26/26), with bilateral MMA supply in 21 cases (80.76%), and unilateral in 5 cases (19.23%). Twenty patients (62.50%, 20/32) received only endovascular treatment (EVT), while four patients had EVT followed by surgery (12.5%, 4/32). Transarterial route via MMA was the preferred treatment option (79.16%). Complete obliteration of fistulas was noted in all cases (100%, 30/30). No immediate complication was noted after EVT. As much as 92.30% patients showed good recovery. Thus, SSS vDAVF forms a special subgroup of DAVF, with aggressive presentation, and warrants urgent treatment. EVT is effective treatment option and can produce complete obliteration.
Keywords
Type III/IV dural arteriovenous fistula on Superior sagittal sinus - Venous ectasia/aneurysm with early rebleed - Endovascular treatmentFinancial Support
We have not received any financial grant for this study.
Patient Consent and Hospital Ethics Committee Approval
We received written informed consent from the patient. We also received approval from Hospital Ethics committee for collection, analysis, and publication of data of this patient.
PRISMA Checklist
Available as supplementary file.
Publication History
Article published online:
09 July 2021
© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Newton TH, Cronqvist S. Involvement of dural arteries in intracranial arteriovenous malformations. Radiology 1969; 93 (05) 1071-1078
- 2 Tsutsumi S, Yasumoto Y, Ito M, Oishi H, Arai H, Yoritaka A. Atypical dural arteriovenous fistula associated with meningitis. Neurol Med Chir (Tokyo) 2008; 48 (02) 68-71
- 3 Borden JA, Wu JK, Shucart WA. A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment. J Neurosurg 1995; 82 (02) 166-179
- 4 Cognard C, Gobin YP, Pierot L. et al. Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Radiology 1995; 194 (03) 671-680
- 5 Kawaguchi T, Nakatani M, Kawano T. Study of dural arteriovenous fistula drains into leptomeningeal vein without sinus interposition. Interv Neuroradiol 2004; 10 (Suppl. 01) 127-134
- 6 Barnwell SL, Halbach VV, Dowd CF, Higashida RT, Hieshima GB, Wilson CB. A variant of arteriovenous fistulas within the wall of dural sinuses. Results of combined surgical and endovascular therapy. J Neurosurg 1991; 74 (02) 199-204
- 7 Halbach VV, Higashida RT, Hieshima GB, Rosenblum M, Cahan L. Treatment of dural arteriovenous malformations involving the superior sagittal sinus. AJNR Am J Neuroradiol 1988; 9 (02) 337-343
- 8 Kawaguchi T, Kawano T, Kaneko Y. et al. Transarterial embolization with HEMA-MMA of variant convexity-superior sagittal sinus dural arteriovenous fistula–case report. Neurol Med Chir (Tokyo) 2000; 40 (07) 366-368
- 9 Hou K, Ji T, Guo Y, Xu B, Xu K, Yu J. Current status of endovascular treatment for dural arteriovenous fistulas in the superior sagittal sinus region: a systematic review of the literature. World Neurosurg 2019; 122: 133-143
- 10 Chaudhary MY, Sachdev VP, Cho SH. Weitzner I Jr, Puljic S, Huang YP. Dural arteriovenous malformation of the major venous sinuses: an acquired lesion. AJNR Am J Neuroradiol 1982; 3 (01) 13-19
- 11 Kurl S, Saari T, Vanninen R, Hernesniemi J. Dural arteriovenous fistulas of superior sagittal sinus: case report and review of literature. Surg Neurol 1996; 45 (03) 250-255
- 12 Cloft HJ, Kallmes DF, Jensen JE, Dion JE. Percutaneous transvenous coil embolization of a type 4 sagittal sinus dural arteriovenous fistula: case report. Neurosurgery 1997; 41 (05) 1191-1193
- 13 Hurst RW, Marcotte P, Raps EC, Flamm ES. Dural arteriovenous fistulas involving the superior sagittal sinus: acute presentation with intracranial hemorrhage. Surg Neurol 1998; 49 (01) 42-46
- 14 Bavinzski G, Schoeggl A, Gruber A, Killer M. Variant arteriovenous fistula of the superior sagittal sinus–case report. Neurol Med Chir (Tokyo) 1999; 39 (05) 362-366
- 15 Fukai J, Terada T, Kuwata T. et al. Transarterial intravenous coil embolization of dural arteriovenous fistula involving the superior sagittal sinus. Surg Neurol 2001; 55 (06) 353-358
- 16 van JM Dijk, terBrugge KG, Willinsky RA, Wallace MC. Clinical course of cranial dural arteriovenous fistulas with long-term persistent cortical venous reflux. Stroke 2002; 33 (05) 1233-1236
- 17 Yoshioka T, Kitagawa N, Yokoyama H, Nagata I. Selective transvenous coil embolization of dural arteriovenous fistula. A report of three cases. Interv Neuroradiol 2007; 13 (Suppl. 01) 123-130
- 18 Koh JS, Ryu CW, Bang JS. et al. Transcranial approach for arterial embolization of dural arteriovenous fistula within the wall of the superior sagittal sinus: a case report. Neurointervention 2007; 2: 117-121
- 19 Toledo MM, Wilson TJ, Dashti S, McDougall CG, Spetzler RF. Dural arteriovenous fistula associated with superior sagittal sinus occlusion secondary to invasion by a parafalcine meningioma: case report. Neurosurgery 2010; 67 (01) 205-207
- 20 Chai EQ, Wang J. Transarterial Onyx embolization of sagittal sinus dural arteriovenous fistulae. Neurol India 2011; 59 (02) 262-265
- 21 Gross BA, Du R. Surgical treatment of high grade dural arteriovenous fistulae. J Clin Neurosci 2013; 20 (11) 1527-1532
- 22 Singla A, Fargen KM, Hoh B. Onyx extrusion through the scalp after embolization of dural arteriovenous fistula. J Neurointerv Surg 2016; 8 (09) e38
- 23 Song W, Sun H, Liu J, Liu L, Liu J. Spontaneous resolution of venous aneurysms after transarterial embolization of a variant superior sagittal sinus dural arteriovenous fistula: Case report and literature review. Neurologist 2017; 22 (05) 186-195
- 24 Kotsugi M, Nakagawa I, Takamura Y, Wada T, Kichikawa K, Nakase H. Transarterial embolization of dural arteriovenous fistula in superior sagittal sinus under bilateral extrenal carotid artery flow control: Technical note. World Neurosurg 2019; 130: 227-230
- 25 Djindjian R, Merland JJ. Superselective Arteriography of the External Carotid Artery. New York:. Springer 1978; 405-412
- 26 Houser OW, Campbell JK, Campbell RJ. Sundt TM Jr. Arteriovenous malformation affecting the transverse dural venous sinus–an acquired lesion. Mayo Clin Proc 1979; 54 (10) 651-661
- 27 Terada T, Higashida RT, Halbach VV. et al. Development of acquired arteriovenous fistulas in rats due to venous hypertension. J Neurosurg 1994; 80 (05) 884-889
- 28 Shin Y, Uranishi R, Nakase H, Sakaki T. Vascular endothelial growth factor expression in the rat dural arteriovenous fistula model. No To Shinkei 2003; 55 (11) 946-952
- 29 Hamada J, Yano S, Kai Y. et al. Histopathological study of venous aneurysms in patients with dural arteriovenous fistulas. J Neurosurg 2000; 92 (06) 1023-1027
- 30 Awad IA, Little JR, Akarawi WP, Ahl J. Intracranial dural arteriovenous malformations: factors predisposing to an aggressive neurological course. J Neurosurg 1990; 72 (06) 839-850
- 31 Lucas CdeP, Caldas JG, Prandini MN. Do leptomeningeal venous drainage and dysplastic venous dilation predict hemorrhage in dural arteriovenous fistula?. Surg Neurol 2006; 66 (Suppl. 03) S2-S5
- 32 Houser OW, Baker Jr HL, Rhoton Jr AL, Okazaki H. Intracranial dural arteriovenous malformations. Radiology 1972; 105 (01) 55-64
- 33 Bulters DO, Mathad N, Culliford D, Millar J, Sparrow OC. The natural history of cranial dural arteriovenous fistulae with cortical venous reflux–the significance of venous ectasia. Neurosurgery 2012; 70 (02) 312-318
- 34 Grisoli F, Vincentelli F, Fuchs S. et al. Surgical treatment of tentorial arteriovenous malformations draining into the subarachnoid space. Report of four cases. J Neurosurg 1984; 60 (05) 1059-1066
- 35 Halbach VV, Higashida RT, Hieshima GB, Mehringer CM, Hardin CW. Transvenous embolization of dural fistulas involving the transverse and sigmoid sinuses. AJNR Am J Neuroradiol 1989; 10 (02) 385-392
- 36 King WA, Martin NA. Intracerebral hemorrhage due to dural arteriovenous malformations and fistulae. Neurosurg Clin N Am 1992; 3 (03) 577-590
- 37 Duffau H, Lopes M, Janosevic V. et al. Early rebleeding from intracranial dural arteriovenous fistulas: report of 20 cases and review of the literature. J Neurosurg 1999; 90 (01) 78-84
- 38 Thompson BG, Doppman JL, Oldfield EH. Treatment of cranial dural arteriovenous fistulae by interruption of leptomeningeal venous drainage. J Neurosurg 1994; 80 (04) 617-623
- 39 Collice M, D’Aliberti G, Talamonti G. et al. Surgical interruption of leptomeningeal drainage as treatment for intracranial dural arteriovenous fistulas without dural sinus drainage. J Neurosurg 1996; 84 (05) 810-817
- 40 Chandler Jr HC, Friedman WA. Successful radiosurgical treatment of a dural arteriovenous malformation: case report. Neurosurgery 1993; 33 (01) 139-141
- 41 Guo WY, Pan DH, Wu HM. et al. Radiosurgery as a treatment alternative for dural arteriovenous fistulas of the cavernous sinus. AJNR Am J Neuroradiol 1998; 19 (06) 1081-1087