Clinical characteristics and outcome of dural arteriovenous fistulas secondary to cerebral venous sinus thrombosis: a primary or secondary event?

Xiaoqin Huang; Huixin Shen; Chunnqiu Fan; Jian Chen; Ran Meng

doi:10.1186/s12883-023-03141-6

Clinical characteristics and outcome of dural arteriovenous fistulas secondary to cerebral venous sinus thrombosis: a primary or secondary event?

BMC Neurol. 2023 Mar 30;23(1):131. doi: 10.1186/s12883-023-03141-6.

Authors

Xiaoqin Huang¹, Huixin Shen², Chunnqiu Fan², Jian Chen³, Ran Meng²

Affiliations

¹ Departments of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China. huangxqxw@126.com.
² Departments of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
³ Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Abstract

Background: The Dural Arteriovenous Fistulas (DAVFs) secondary to cerebral venous sinus thrombosis (CVST) are rather rare. The aim of present study is to investigate the clinical and radiological features, and treatment outcome of DAVFS in patients following CVST.

Methods: Data about demographic information, clinical presentations, radiological findings, as well as treatment and outcome of DAVFs sequence to CVST were collected to analysis from January 2013 to September 2020 in this retrospective study.

Results: Fifteen patients with DAVFs after CVST were included in the study. The median age was 41 years (range17-76 years). Ten patients (66.67%) were male and 6 patients (33.33%) were female. The median duration of presenting CVST was 182 days (Range 20-365). Mean time from diagnosis of CVST to confirmation of DAVFs was 97 days (range 36-370 days). The most common manifestations of DAVFs following CVST were headache and visual disturbance seen in 7 patients respectively. Five patients had pulsatile tinnitus (%) and 2 had nausea/vomiting. The DAVFs are most frequently located at the transverse/sigmoid sinus (7/15, 46.67%), followed by the superior sagittal the sinus and confluence sinus (6/15, 40.00%) respectively. Angiography of DAVFs revealed Board type I in seven (46.7%) patients, Board type II and III in 4(26.7%) patients, respectively. The Cognard I was noted in seven (46.7%), Cognard IIa and IV in 3 patients, IIb and III in one patient, respectively. The main feeding arteries of DAVFs most commonly originate from the branches of the external carotid artery in 6 (40.0%) patients. The other DAVFs are conjointly supplied by multiple feeders from internal and external carotid artery and vertebral arteries. Fourteen (93.33%) patients were treated with endovascular embolization and none of the patients had permanent deficits during follow-up.

Conclusion: Intracranial DAVFs following CVST are rare presentations. Most patients have a good outcome after timely interventional therapy. Continued observation and follow-up of (DSA) are important to find DAVFs secondary to CVST.

Keywords: Arteriovenous malformation; Cerebral venous sinus thrombosis; Dural arteriovenous fistula.

MeSH terms

Adult
Central Nervous System Vascular Malformations* / complications
Central Nervous System Vascular Malformations* / diagnostic imaging
Central Nervous System Vascular Malformations* / therapy
Cerebral Angiography
Cranial Sinuses
Embolization, Therapeutic*
Female
Humans
Male
Retrospective Studies
Sinus Thrombosis, Intracranial* / complications
Sinus Thrombosis, Intracranial* / diagnostic imaging
Sinus Thrombosis, Intracranial* / therapy
Treatment Outcome