Venous congestive encephalopathy related to cranial dural arteriovenous fistulas

Neuroimaging Clin N Am. 2003 Feb;13(1):55-72. doi: 10.1016/s1052-5149(02)00063-1.


Cranial DAVFs present with a wide spectrum of clinical findings from pulsatile tinnitus alone to intracranial hemorrhage and NHND. The neurologic sequelae are a consequence of venous hypertension and venous congestion. DAVFs with CVR can present with or develop a VCE that can be recognized on MR imaging as a diffuse T2 hyperintensity in the deep white matter of the cerebral or cerebellar hemispheres. The T2 hyperintensity has a characteristic peripheral enhancement. The telltale sign on MR imaging is the plethora of prominent pial vessels on the surface of the brain that are the engorged cortical veins participating in the cortical venous reflux. Selective angiography is critical for the accurate assessment of the CVR. DAVFs with CVR require prompt treatment, either endovascular alone or a combination of endovascular treatment and surgery.

Publication types

  • Review

MeSH terms

  • Brain Damage, Chronic / diagnostic imaging*
  • Brain Damage, Chronic / etiology
  • Brain Damage, Chronic / pathology*
  • Central Nervous System Vascular Malformations / complications
  • Central Nervous System Vascular Malformations / diagnostic imaging*
  • Central Nervous System Vascular Malformations / pathology*
  • Cerebral Angiography
  • Cerebral Veins / diagnostic imaging*
  • Cerebral Veins / pathology*
  • Cerebral Veins / physiology
  • Cerebrovascular Circulation / physiology
  • Humans
  • Hydrocephalus / diagnostic imaging*
  • Hydrocephalus / etiology
  • Hydrocephalus / pathology*
  • Magnetic Resonance Imaging
  • Phlebography
  • Tomography, X-Ray Computed