Intracranial dural arteriovenous fistulas with or without cerebral sinus thrombosis: Analysis of 69 patients

L. K. Tsai, J. S. Jeng, H. M. Liu, Hung-Jung Wang, P. K. Yip

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Abstract

Objectives: To compare the characteristics of dural arteriovenous fistulas (AVFs) with or without cerebral sinus thrombosis (CST), and to analyse the determinants of aggressive manifestations in patients with dural AVF. Methods: We investigated 69 patients aged 51.4 (SD 15) years who were diagnosed as having dural AVF. According to the location of the lesion and venous drainage pattern, dural AVF was classified into three sites (cavernous sinus, large sinus, and other) and five types (by Cognard's method). Aggressive manifestations of dural AVF were defined as intracranial haemorrhage, venous infarction, seizure, altered mental status, and intracranial hypertension. The diagnosis of CST was based on cerebral angiogrqphy. Logistic regression methods were used to analyse the determinants of aggressive manifestation in patients with dural AVF. Results: CST was found in 39% of the patients with dural AVF. It was located at almost either the sinus around the dural AVF or the downstream venous flow pathways of the dural AVF. There was no significant difference with regard to sex, location, or type of dural AVF between patients with dural AVF with and without CST. The location "other sinuses" and the type of dural AVF "IIb/IIa+b/III/IV/V" were significantly related to aggressive manifestations of dural AVF (odds ratio 19 (p=0.001) and 5.63 (p=0.033), respectively). Presence of CST in patients with dural AVF had an odds ratio of 4.25 (p=0.12) for development of aggressive manifestations. Conclusions: CST affects two fifths of patients with dural AVF. The location and type of dural AVF are major determinants of aggressive manifestations in patients with dural AVF.

Original languageEnglish
Pages (from-to)1639-1641
Number of pages3
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume75
Issue number11
DOIs
Publication statusPublished - Nov 1 2004
Externally publishedYes

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Central Nervous System Vascular Malformations
Intracranial Sinus Thrombosis
Intracranial Thrombosis
Odds Ratio
Cavernous Sinus
Intracranial Hypertension

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Intracranial dural arteriovenous fistulas with or without cerebral sinus thrombosis : Analysis of 69 patients. / Tsai, L. K.; Jeng, J. S.; Liu, H. M.; Wang, Hung-Jung; Yip, P. K.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 75, No. 11, 01.11.2004, p. 1639-1641.

Research output: Contribution to journalArticle

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AU - Jeng, J. S.

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AU - Yip, P. K.

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N2 - Objectives: To compare the characteristics of dural arteriovenous fistulas (AVFs) with or without cerebral sinus thrombosis (CST), and to analyse the determinants of aggressive manifestations in patients with dural AVF. Methods: We investigated 69 patients aged 51.4 (SD 15) years who were diagnosed as having dural AVF. According to the location of the lesion and venous drainage pattern, dural AVF was classified into three sites (cavernous sinus, large sinus, and other) and five types (by Cognard's method). Aggressive manifestations of dural AVF were defined as intracranial haemorrhage, venous infarction, seizure, altered mental status, and intracranial hypertension. The diagnosis of CST was based on cerebral angiogrqphy. Logistic regression methods were used to analyse the determinants of aggressive manifestation in patients with dural AVF. Results: CST was found in 39% of the patients with dural AVF. It was located at almost either the sinus around the dural AVF or the downstream venous flow pathways of the dural AVF. There was no significant difference with regard to sex, location, or type of dural AVF between patients with dural AVF with and without CST. The location "other sinuses" and the type of dural AVF "IIb/IIa+b/III/IV/V" were significantly related to aggressive manifestations of dural AVF (odds ratio 19 (p=0.001) and 5.63 (p=0.033), respectively). Presence of CST in patients with dural AVF had an odds ratio of 4.25 (p=0.12) for development of aggressive manifestations. Conclusions: CST affects two fifths of patients with dural AVF. The location and type of dural AVF are major determinants of aggressive manifestations in patients with dural AVF.

AB - Objectives: To compare the characteristics of dural arteriovenous fistulas (AVFs) with or without cerebral sinus thrombosis (CST), and to analyse the determinants of aggressive manifestations in patients with dural AVF. Methods: We investigated 69 patients aged 51.4 (SD 15) years who were diagnosed as having dural AVF. According to the location of the lesion and venous drainage pattern, dural AVF was classified into three sites (cavernous sinus, large sinus, and other) and five types (by Cognard's method). Aggressive manifestations of dural AVF were defined as intracranial haemorrhage, venous infarction, seizure, altered mental status, and intracranial hypertension. The diagnosis of CST was based on cerebral angiogrqphy. Logistic regression methods were used to analyse the determinants of aggressive manifestation in patients with dural AVF. Results: CST was found in 39% of the patients with dural AVF. It was located at almost either the sinus around the dural AVF or the downstream venous flow pathways of the dural AVF. There was no significant difference with regard to sex, location, or type of dural AVF between patients with dural AVF with and without CST. The location "other sinuses" and the type of dural AVF "IIb/IIa+b/III/IV/V" were significantly related to aggressive manifestations of dural AVF (odds ratio 19 (p=0.001) and 5.63 (p=0.033), respectively). Presence of CST in patients with dural AVF had an odds ratio of 4.25 (p=0.12) for development of aggressive manifestations. Conclusions: CST affects two fifths of patients with dural AVF. The location and type of dural AVF are major determinants of aggressive manifestations in patients with dural AVF.

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