Przetoki tętniczo-żylne opony twardej
Epidemiologia

Przetoki tętniczo-żylne opony twardej (DAVF) stanowią 10-15% wszystkich wewnątrzczaszkowych malformacji naczyniowych, z częstością występowania 0,15-0,29/100 000 rocznie. Lokalizują się najczęściej w zatoce poprzecznej (50%), jamistej (16%), namiotu móżdżku (12%) i zatoki strzałkowej górnej (8%). Występują głównie u osób w wieku 40-60 lat, z niejednoznaczną predylekcją płciową, choć u mężczyzn obserwuje się wyższe ryzyko krwawienia. Przetoki rdzeniowe (SDAVF) stanowią 70% malformacji rdzenia kręgowego, z częstością 5-10/milion rocznie, dominując u mężczyzn w piątej i szóstej dekadzie życia, głównie w segmencie T6-L2 (80%). Etiologia DAVF jest najczęściej nabyta, związana z zakrzepicą zatok żylnych, urazami, zabiegami neurochirurgicznymi, infekcjami i guzami, prowadząc do niedrożności i nadciśnienia żylnego, co sprzyja powstawaniu patologicznych połączeń tętniczo-żylnych.

Epidemiologia przetok tętniczo-żylnych opony twardej

Przetoki tętniczo-żylne opony twardej (DAVF, ang. Dural Arteriovenous Fistulas) stanowią stosunkowo rzadką, lecz istotną klinicznie grupę zmian naczyniowych. Są to nieprawidłowe połączenia między tętnicami oponowymi a zatokami żylnymi i/lub żyłami korowymi. Szacuje się, że stanowią one 10-15% wszystkich wewnątrzczaszkowych malformacji naczyniowych, a ich częstość występowania wynosi około 0,15-0,29 przypadków na 100 000 osób rocznie.123

Wśród malformacji naczyniowych nadnamiotowych przetoki te stanowią około 6%, natomiast wśród malformacji podnamiotowych – aż 35%.4 Lokalizacja przetok naczyniowych opony twardej jest zróżnicowana, przy czym najczęściej występują one w obrębie zatoki poprzecznej (50%), zatoki jamistej (16%), namiotu móżdżku (12%) oraz zatoki strzałkowej górnej (8%).5

Występowanie DAVF w różnych grupach wiekowych

Przetoki tętniczo-żylne opony twardej najczęściej występują u osób w wieku 40-60 lat.67 Większość przypadków DAVF diagnozowana jest u dorosłych w piątej lub szóstej dekadzie życia. Zmiany te rzadko występują u dzieci i młodzieży, stanowiąc mniej niż 1% wszystkich przypadków.8 Dziecięce DAVF charakteryzują się odmienną prezentacją kliniczną i często gorszym rokowaniem w porównaniu do przypadków występujących u dorosłych.9

Różnice w występowaniu ze względu na płeć

Dane dotyczące predylekcji płciowej w występowaniu DAVF są niejednoznaczne. Część badań sugeruje brak wyraźnych różnic w występowaniu między kobietami a mężczyznami, podczas gdy inne wskazują na częstsze występowanie u kobiet (61-66%).1011 Jednocześnie zaobserwowano, że u mężczyzn występuje zwiększone ryzyko krwawienia związanego z DAVF w porównaniu do kobiet.12

Przetoki tętniczo-żylne opony twardej lędźwiowo-krzyżowej

Przetoki tętniczo-żylne opony twardej rdzenia kręgowego (SDAVF, ang. Spinal Dural Arteriovenous Fistulas) stanowią najczęstszy typ malformacji naczyniowych rdzenia kręgowego, odpowiadając za około 70% wszystkich zmian naczyniowych w tym obszarze.131415 Szacunkowa częstość występowania SDAVF wynosi 5-10 przypadków na milion osób rocznie, jednak istnieją przesłanki sugerujące, że rzeczywista liczba może być wyższa, a schorzenie to jest często niedodiagnozowane.1617

SDAVF dotyczą głównie mężczyzn w piątej i szóstej dekadzie życia, przy czym mężczyźni chorują 5 razy częściej niż kobiety.1819 Praktycznie nie odnotowano przypadków SDAVF u pacjentów poniżej 20 roku życia, a osoby poniżej 30 roku życia stanowią mniej niż 1% wszystkich przypadków.20

Lokalizacja przetok tętniczo-żylnych opony twardej rdzenia kręgowego

Większość SDAVF to zmiany pojedyncze, zlokalizowane w regionie piersiowo-lędźwiowym. Według danych około 80% wszystkich przetok tętniczo-żylnych opony twardej rdzenia kręgowego znajduje się między poziomami T6 i L2.21 Przetoki w obrębie kości krzyżowej występują u około 4% pacjentów, natomiast zmiany w górnej części odcinka szyjnego (na poziomie otworu wielkiego) obserwuje się u 2% chorych. Przetoki w dolnej części odcinka szyjnego (poniżej C2 i powyżej T1) są niezwykle rzadkie.22

U około 2% pacjentów mogą występować podwójne SDAVF lub połączenie SDAVF z tętniczo-żylną przetoką oponową rdzenia, co sugeruje potencjalny związek etiologiczny między tymi stanami.23

Etiologia i mechanizmy powstawania przetok tętniczo-żylnych opony twardej

Dokładna etiologia przetok tętniczo-żylnych opony twardej nie jest w pełni poznana, jednak większość DAVF u dorosłych wydaje się być nabyta, a nie wrodzona.2425 Fakt, że większość pacjentów staje się objawowa w średnim wieku, sugeruje, że jest to schorzenie nabyte.26

Wśród potencjalnych czynników przyczyniających się do rozwoju DAVF wymienia się:

  • Zakrzepicę zatok żylnych opony twardej2728
  • Urazy głowy29
  • Przebyte zabiegi neurochirurgiczne30
  • Infekcje31
  • Guzy32

Nie zidentyfikowano związków z historią rodzinną ani uwarunkowaniami genetycznymi.33

Mechanizm powstawania przetok

Kluczowym czynnikiem w rozwoju DAVF, zarówno u dorosłych, jak i u dzieci, wydaje się być zmniejszony przepływ krwi i późniejsza niedrożność oraz wytworzenie się przetok w obrębie zatoki żylnej opony twardej.34 Powstała niedrożność i nadciśnienie żylne powodują rozszerzenie naczyń włosowatych, które otwierają bezpośrednie połączenia między tętnicami i żyłami opony twardej.35

Około 60% SDAVF powstaje samoistnie, pozostałe 40% jest spowodowanych urazami.36 W przypadku przetok zlokalizowanych w rdzeniu kręgowym, dokładna etiologia również pozostaje niejasna, ale większość pacjentów staje się objawowa w średnim wieku, co sugeruje nabyty charakter tych zmian.37

Nadzór i diagnostyka przetok tętniczo-żylnych opony twardej

Diagnostyka przetok tętniczo-żylnych opony twardej pozostaje wyzwaniem ze względu na ich rzadkość i niespecyficzne objawy kliniczne. Rozpoznanie DAVF często jest opóźnione, co może prowadzić do poważnych konsekwencji zdrowotnych.3839

Metody diagnostyczne

Podstawowymi metodami diagnostycznymi w rozpoznawaniu DAVF są:

  • Obrazowanie metodą rezonansu magnetycznego (MRI)40
  • Angiografia cyfrowa subtrakcyjna (DSA) – nadal uważana za złoty standard w diagnostyce przetok4142
  • Czasowo rozdzielcza angiografia rezonansu magnetycznego (trMRA) – obiecująca technika nieinwazyjna do badań przesiewowych i kontrolnych w określonych sytuacjach klinicznych43

Nadzór i monitorowanie

Ze względu na ryzyko progresji i potencjalnie poważne powikłania, pacjenci z DAVF wymagają regularnego monitorowania. Badania kontrolne mają szczególne znaczenie w przypadku:44

  • Pacjentów po zakrzepicy zatok żylnych opony twardej (CVST) – u których mogą rozwinąć się wtórne DAVF45
  • Pacjentów z bezobjawowymi przetokami – wymagających ścisłej obserwacji klinicznej i kontrolnych badań obrazowych46
  • Pacjentów po leczeniu – w celu oceny skuteczności terapii i ewentualnego nawrotu47

Międzynarodowe rejestry i badania

W celu lepszego zrozumienia patofizjologii, charakterystyki obrazowej, naturalnego przebiegu i wyników leczenia DAVF, utworzono międzynarodowe konsorcjum badawcze CONDOR (Consortium for Dural Arteriovenous Fistula Outcomes Research). Obejmuje ono 14 ośrodków z USA, Wielkiej Brytanii, Holandii i Japonii, które zebrały dane od 1077 pacjentów z DAVF leczonych w latach 1990-2017.48

Rejestr CONDOR stanowi największą na świecie bazę danych pacjentów z DAVF, co umożliwia przeprowadzenie wielu analiz w celu lepszego zrozumienia tej jednostki chorobowej i optymalizacji jej leczenia.49

Prezentacja kliniczna przetok tętniczo-żylnych opony twardej

Objawy kliniczne przetok tętniczo-żylnych opony twardej są bardzo zróżnicowane i zależą od lokalizacji oraz wzorca drenażu żylnego. Według danych z rejestru CONDOR, spośród 1077 pacjentów, 852 (79%) prezentowało objawy związane z przetoką, natomiast u 224 (21%) przetoki wykryto przypadkowo i były bezobjawowe.50

Wśród pacjentów z objawami klinicznymi:

  • 427 (40%) prezentowało objawy nieagresywne, takie jak szumy uszne lub zjawiska oczodołowe51
  • 258 (24%) prezentowało krwotok wewnątrzczaszkowy52
  • 167 (16%) prezentowało niehemorrhagiczne deficyty neurologiczne53

Objawy kliniczne w zależności od lokalizacji

Objawy przetok tętniczo-żylnych opony twardej różnią się w zależności od ich lokalizacji:

  • Przetoki w obrębie tylnego dołu czaszki – mogą powodować demencję wzgórzową, co jest rzadkim, ale istotnym klinicznie objawem54
  • Przetoki rdzeniowe (SDAVF) – najczęściej objawiają się zaburzeniami chodu lub osłabieniem kończyn dolnych oraz zaburzeniami czucia55
  • Przetoki związane z tętniakmi – stanowią około 10% wszystkich wewnątrzczaszkowych DAVF i często lokalizują się w obrębie przedniego dołu czaszki56

Roczne wskaźniki powikłań

Badania naturalnego przebiegu DAVF wykazały następujące roczne wskaźniki powikłań:57

  • W przypadku bezobjawowych przetok typu II-IV: 2,3% dla niehemorrhagicznego deficytu neurologicznego (NHND) i 2,9% dla krwotoku58
  • W przypadku przetok objawiających się NHND: 23,1% dla dalszego pogłębiania NHND i 3,3% dla krwotoku59
  • W przypadku przetok objawiających się krwotokiem: 0% dla NHND i 46,2% dla ponownego krwotoku60

Czynniki ryzyka powikłań

Analiza wieloczynnikowa wykazała, że istotnymi czynnikami ryzyka wystąpienia niehemorrhagicznego deficytu neurologicznego (NHND) są:61

  • Wcześniejsza prezentacja NHND (HR 11,49, 95% CI 3,19-63)62
  • Drenaż żylny oponowy (HR 5,03, 95% CI 0,42-694)63

Natomiast istotnymi czynnikami ryzyka krwotoku są:64

  • Wcześniejsza prezentacja krwotoczna (HR 17,67, 95% CI 2,99-117)65
  • Drenaż żylny oponowy (HR 10,39, 95% CI 1,11-1384)66

Stratyfikacja ryzyka i rokowanie w przetokach tętniczo-żylnych opony twardej

Stratyfikacja ryzyka w przetokach tętniczo-żylnych opony twardej jest kluczowa dla określenia optymalnej strategii leczenia i prognozowania wyników. Podstawowym czynnikiem prognostycznym jest obecność lub brak drenażu żylnego korowego.67

Klasyfikacja i ocena ryzyka

Do oceny ryzyka powikłań DAVF stosuje się głównie klasyfikacje Bordena i Cognarda, które uwzględniają wzorzec drenażu żylnego. Według klasyfikacji Bordena:68

  • Typ I – najniższe ryzyko (drenaż do zatoki żylnej bez refluksu)
  • Typ II – pośrednie ryzyko (drenaż do zatoki żylnej z refluksem do żył korowych)
  • Typ III – najwyższe ryzyko (bezpośredni drenaż do żył korowych)

W rejestrze CONDOR z 1077 pacjentów: 359 (33%) miało przetoki typu I wg Bordena, 175 (16%) – typu II, a 529 (49%) – typu III.69

Rokowanie i śmiertelność

Rokowanie w DAVF zależy od wielu czynników, w tym lokalizacji przetoki, wzorca drenażu żylnego i wystąpienia powikłań krwotocznych:70

  • Przy wczesnym wykryciu i leczeniu rokowanie jest pozytywne71
  • Roczny wskaźnik śmiertelności szacuje się na 11-19%72
  • Roczny wskaźnik przeżycia wynosi powyżej 80% w niektórych przypadkach73

W przypadku przetok typu II-IV wg Bordena zaleca się rozważenie leczenia ze względu na podwyższone ryzyko powikłań. Przetoki objawiające się NHND i/lub krwotokiem powinny być leczone w trybie pilnym ze względu na wysokie ryzyko ponownego krwawienia.74

Rokowanie w przetokach rdzeniowych

W przypadku przetok tętniczo-żylnych opony twardej rdzenia kręgowego (SDAVF), wczesna diagnoza jest kluczowa, ponieważ deficyty neurologiczne mogą być potencjalnie odwracalne, ale opóźnione leczenie może prowadzić do nieodwracalnej niepełnosprawności neurologicznej.75 Naturalny przebieg kliniczny nieleczonych objawowych SDAVF to stopniowe pogorszenie z potencjalnym ryzykiem nieodwracalnego uszkodzenia rdzenia kręgowego.76

Przetoki w populacji pediatrycznej

Dziecięce przetoki tętniczo-żylne opony twardej charakteryzują się rzadkością występowania, odmiennymi manifestacjami klinicznymi, niskim wskaźnikiem wyleczenia i często gorszym rokowaniem niż u dorosłych.77 Szczególnie przetoki typu niemowlęcego mają gorsze rokowanie i wymagają ścisłego długoterminowego monitorowania.78

Większość DAVF typu dorosłego i zatokowych malformacji opony twardej (DSM) u dzieci można skutecznie leczyć embolizacją, uzyskując dobre wyniki i rokowanie. Jednak leczenie DAVF typu niemowlęcego pozostaje wyzwaniem, a rokowanie jest często niekorzystne.79

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  1. 10.04.2026
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Materiały źródłowe

  • #1 Dural Arteriovenous Fistula – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK532274/
    Dural arteriovenous fistulas can present at any age but are most commonly diagnosed between the ages of 40 and 60. […] The dAVFs account for 10-15% of all cerebral vascular malformations. […] Incidence is approximately 0.15 – 0.29 per 100,000 persons per year.
  • #2 Dural Arteriovenous Fistulas: Epidemiology and Clinical Presentation | Neupsy Key
    https://neupsykey.com/dural-arteriovenous-fistulas-epidemiology-and-clinical-presentation/
    Dural arteriovenous fistulas (DAVFs) present at a mean age of 50 to 60 years, but individual presentation is highly heterogeneous. […] In the past, DAVFs were relatively uncommon, but are now being diagnosed with increased frequency. […] These lesions account for approximately 10% to 15% of intracranial vascular malformations. […] Among supratentorial and infratentorial vascular malformations, they account for 6% and 35% of lesions, respectively. […] These lesions seem to have no gender preponderance, but several studies have reported an increased incidence of hemorrhage in men in comparison with women. […] No linkages to family history or genetics have been identified.
  • #3 Journal of Cerebrovascular and Endovascular Neurosurgery
    https://the-jcen.org/m/journal/view.php?number=809
    Dural arteriovenous fistulas (DAVFs) are pathologic shunts between pachymeningeal arteries and dural venous channel. DAVFs are relatively rare, however, DAVFs can lead to significant morbidity and mortality due to intracranial hemorrhage and non-hemorrhagic neurologic deterioration related to leptomeningeal venous drainage. […] The incidence of cranial DAVFs has been estimated 0.15-0.29/100,000 per year and the intracranial location is reported as transverse sinus (50%), cavernous sinus (16%), tentorium cerebelli (12%), and superior sagittal sinus (8%). […] DAVFs are relatively rare, accounting for 5-15% of all cranial vascular malformation. However, DAVFs can lead to significant morbidity and mortality due to intracranial hemorrhage and non-hemorrhagic neurologic deterioration related to leptomeningeal venous drainage.
  • #4 Dural Arteriovenous Fistulas: Epidemiology and Clinical Presentation | Neupsy Key
    https://neupsykey.com/dural-arteriovenous-fistulas-epidemiology-and-clinical-presentation/
    Dural arteriovenous fistulas (DAVFs) present at a mean age of 50 to 60 years, but individual presentation is highly heterogeneous. […] In the past, DAVFs were relatively uncommon, but are now being diagnosed with increased frequency. […] These lesions account for approximately 10% to 15% of intracranial vascular malformations. […] Among supratentorial and infratentorial vascular malformations, they account for 6% and 35% of lesions, respectively. […] These lesions seem to have no gender preponderance, but several studies have reported an increased incidence of hemorrhage in men in comparison with women. […] No linkages to family history or genetics have been identified.
  • #5 Journal of Cerebrovascular and Endovascular Neurosurgery
    https://the-jcen.org/m/journal/view.php?number=809
    Dural arteriovenous fistulas (DAVFs) are pathologic shunts between pachymeningeal arteries and dural venous channel. DAVFs are relatively rare, however, DAVFs can lead to significant morbidity and mortality due to intracranial hemorrhage and non-hemorrhagic neurologic deterioration related to leptomeningeal venous drainage. […] The incidence of cranial DAVFs has been estimated 0.15-0.29/100,000 per year and the intracranial location is reported as transverse sinus (50%), cavernous sinus (16%), tentorium cerebelli (12%), and superior sagittal sinus (8%). […] DAVFs are relatively rare, accounting for 5-15% of all cranial vascular malformation. However, DAVFs can lead to significant morbidity and mortality due to intracranial hemorrhage and non-hemorrhagic neurologic deterioration related to leptomeningeal venous drainage.
  • #6 Dural Arteriovenous Fistula – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK532274/
    Dural arteriovenous fistulas can present at any age but are most commonly diagnosed between the ages of 40 and 60. […] The dAVFs account for 10-15% of all cerebral vascular malformations. […] Incidence is approximately 0.15 – 0.29 per 100,000 persons per year.
  • #7 Dural arteriovenous fistulas – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/dural-arteriovenous-fistulas/symptoms-causes/syc-20364280
    Dural arteriovenous fistulas (dAVFs) are irregular connections between arteries and veins. They occur in the tough covering over the brain or spinal cord, known as the dura mater. Dural AVFs are rare. They tend to occur between ages 50 and 60. Most often, dAVFs affect people between ages 50 and 60. But they can occur in people at younger ages, including in children. Most dural arteriovenous fistulas (dAVFs) have no clear origin. But some result from a traumatic head injury, infection, previous brain surgery, blood clots in deep veins or tumors. Risk factors of dural arteriovenous fistulas (dAVFs) include being inclined to blood clots in the vein, known as vein thrombosis. Changes in the way the blood clots may increase the risk of a blockage or narrowing of the venous sinuses. […] Research has found that noncancerous tumors found in the membranes that surround the brain and spinal cord may be associated with dAVFs.
  • #8 Dural arteriovenous fistula – Wikipedia
    https://en.wikipedia.org/wiki/Dural_arteriovenous_fistula
    1015% of intracranial AV malformations are DAVFs. There is a higher preponderance in females (6166%), and typically patients are in their fourth or fifth decade of life. DAVFs are rarer in children.
  • #9 Paediatric intracranial dural arteriovenous fistulas: clinical characteristics, treatment outcomes and prognosis | Stroke and Vascular Neurology
    https://svn.bmj.com/content/early/2024/06/05/svn-2024-003122
    Paediatric dural arteriovenous fistulas (DAVFs) are notable for their rarity, distinct clinical manifestations, low cure rate and poor prognosis in some case series or reports. […] The long-term follow-up results indicate that infantile-type DAVFs has a poorer prognosis. It is extremely necessary to closely monitor them in the long term. […] Most adult-type DAVFs and DSMs can now be effectively treated with embolisation, resulting in good outcomes and prognosis. However, there are still challenges in treating infantile-type DAVFs, and the prognosis is frequently poor. […] Paediatric DAVFs are notable for their rarity, distinct clinical manifestations, low cure rate and poor prognosis. Most adult-type DAVFs and DSMs can now be effectively treated with embolisation, resulting in good outcomes and prognosis. However, there are still challenges in treating infantile-type DAVFs, and the prognosis is frequently poor.
  • #10 Dural arteriovenous fistula – Wikipedia
    https://en.wikipedia.org/wiki/Dural_arteriovenous_fistula
    1015% of intracranial AV malformations are DAVFs. There is a higher preponderance in females (6166%), and typically patients are in their fourth or fifth decade of life. DAVFs are rarer in children.
  • #11 Dural Arteriovenous Fistulas: Epidemiology and Clinical Presentation | Neupsy Key
    https://neupsykey.com/dural-arteriovenous-fistulas-epidemiology-and-clinical-presentation/
    Dural arteriovenous fistulas (DAVFs) present at a mean age of 50 to 60 years, but individual presentation is highly heterogeneous. […] In the past, DAVFs were relatively uncommon, but are now being diagnosed with increased frequency. […] These lesions account for approximately 10% to 15% of intracranial vascular malformations. […] Among supratentorial and infratentorial vascular malformations, they account for 6% and 35% of lesions, respectively. […] These lesions seem to have no gender preponderance, but several studies have reported an increased incidence of hemorrhage in men in comparison with women. […] No linkages to family history or genetics have been identified.
  • #12 Dural Arteriovenous Fistulas: Epidemiology and Clinical Presentation | Neupsy Key
    https://neupsykey.com/dural-arteriovenous-fistulas-epidemiology-and-clinical-presentation/
    Dural arteriovenous fistulas (DAVFs) present at a mean age of 50 to 60 years, but individual presentation is highly heterogeneous. […] In the past, DAVFs were relatively uncommon, but are now being diagnosed with increased frequency. […] These lesions account for approximately 10% to 15% of intracranial vascular malformations. […] Among supratentorial and infratentorial vascular malformations, they account for 6% and 35% of lesions, respectively. […] These lesions seem to have no gender preponderance, but several studies have reported an increased incidence of hemorrhage in men in comparison with women. […] No linkages to family history or genetics have been identified.
  • #13 Spinal Dural Arteriovenous Fistulas | American Journal of Neuroradiology
    http://www.ajnr.org/content/30/4/639
    SDAVFs are the most frequent vascular malformation of the spine and account for approximately 70% of all vascular spinal malformations. An estimation based on the retrospective series of the major German referral center for spinal vascular diseases arrived at 510/million/year in the general population. However, the disease seems to be underdiagnosed. Usually, SDAVFs become symptomatic in elderly men. A recent meta-analysis concluded that men are affected 5 times more often than women and that the mean age at the time of diagnosis is 55-60 years. Patients younger than 30 years of age constituted less than 1% of patients with a DAVF, whereas, to our knowledge, no patient younger than 20 years of age has ever been reported. Most fistulas are solitary lesions and are found in the thoracolumbar region. In our experience, 80% of all DAVFs are located between T6 and L2. Sacral lesions occur in approximately 4% of patients, whereas high cervical lesions (at the level of the foramen magnum) occur in 2% of patients. Low cervical DAVFs (below C2 and above T1) are extremely rare. In approximately 2% of patients, double spinal DAVFs or an association of a spinal dural with a spinal pial AV shunt may be present, raising the possibility of a potential etiologic connection.
  • #14 Spinal dural arteriovenous fistula | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/spinal-dural-arteriovenous-fistula?lang=us
    Spinal dural arteriovenous fistulas (SDAVF) are the most common type of spinal vascular malformation, accounting for ~70% of all such lesions. […] The incidence of SDAVF peaks in the 5th and 6th decades and males are more commonly affected than females. […] Nearly 60% of SDAVFs are spontaneous, with the remainder being caused by trauma.
  • #15 Arteriovenous Malformations and Fistulas (AVM/AVF) of the Spinal Cord: Practice Essentials, Background, History of the Procedure
    https://emedicine.medscape.com/article/459842-overview
    Dural AVF. This is the most common type of malformation, accounting for 70% of all spinal vascular malformations. These fistulas are created when a radiculomeningeal artery feeds directly into a radicular vein, usually near the spinal nerve root. Dural AVFs are most commonly found in the thoracolumbar region. Patients with these malformations become symptomatic because the AVF creates venous congestion and hypertension, resulting in hypoperfusion, hypoxia, and edema of the spinal cord. Due to the slow-flow nature of dural AVFs, hemorrhage rarely occurs. Most dural AVFs are believed to occur spontaneously, but the exact etiology remains unknown. These lesions are most frequently found in men between the fifth and eighth decades of life.
  • #16 Spinal Dural Arteriovenous Fistulas | American Journal of Neuroradiology
    http://www.ajnr.org/content/30/4/639
    SDAVFs are the most frequent vascular malformation of the spine and account for approximately 70% of all vascular spinal malformations. An estimation based on the retrospective series of the major German referral center for spinal vascular diseases arrived at 510/million/year in the general population. However, the disease seems to be underdiagnosed. Usually, SDAVFs become symptomatic in elderly men. A recent meta-analysis concluded that men are affected 5 times more often than women and that the mean age at the time of diagnosis is 55-60 years. Patients younger than 30 years of age constituted less than 1% of patients with a DAVF, whereas, to our knowledge, no patient younger than 20 years of age has ever been reported. Most fistulas are solitary lesions and are found in the thoracolumbar region. In our experience, 80% of all DAVFs are located between T6 and L2. Sacral lesions occur in approximately 4% of patients, whereas high cervical lesions (at the level of the foramen magnum) occur in 2% of patients. Low cervical DAVFs (below C2 and above T1) are extremely rare. In approximately 2% of patients, double spinal DAVFs or an association of a spinal dural with a spinal pial AV shunt may be present, raising the possibility of a potential etiologic connection.
  • #17 Journal of Cerebrovascular and Endovascular Neurosurgery
    https://the-jcen.org/m/journal/view.php?number=809
    The etiology of DAVFs is not fully understood, but the majority of DAVFs in adulthood appear to be acquired. […] Spinal DAVFs are reported to affect 0.5-1/100,000 per year and precise incidence of the rest of spinal vascular lesions is lacking. […] Spinal DAVFs are thought to be acquired lesions and preferentially affect middle-aged men. […] The most frequent location is in the lower thoracic and upper lumbar area and patients most commonly present with gait abnormality or lower-extremity weakness and sensory disturbances. […] Spinal DAVFs are defined by pathologic shunt between a radicular artery and coronal venous plexus of the spine without an intervening capillary bed. They are the most common type of spinal cord vascular malformation, accounting for 50% to 85% of all spinal vascular lesions.
  • #18 Spinal Dural Arteriovenous Fistulas | American Journal of Neuroradiology
    http://www.ajnr.org/content/30/4/639
    SDAVFs are the most frequent vascular malformation of the spine and account for approximately 70% of all vascular spinal malformations. An estimation based on the retrospective series of the major German referral center for spinal vascular diseases arrived at 510/million/year in the general population. However, the disease seems to be underdiagnosed. Usually, SDAVFs become symptomatic in elderly men. A recent meta-analysis concluded that men are affected 5 times more often than women and that the mean age at the time of diagnosis is 55-60 years. Patients younger than 30 years of age constituted less than 1% of patients with a DAVF, whereas, to our knowledge, no patient younger than 20 years of age has ever been reported. Most fistulas are solitary lesions and are found in the thoracolumbar region. In our experience, 80% of all DAVFs are located between T6 and L2. Sacral lesions occur in approximately 4% of patients, whereas high cervical lesions (at the level of the foramen magnum) occur in 2% of patients. Low cervical DAVFs (below C2 and above T1) are extremely rare. In approximately 2% of patients, double spinal DAVFs or an association of a spinal dural with a spinal pial AV shunt may be present, raising the possibility of a potential etiologic connection.
  • #19 Spinal dural arteriovenous fistula | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/spinal-dural-arteriovenous-fistula?lang=us
    Spinal dural arteriovenous fistulas (SDAVF) are the most common type of spinal vascular malformation, accounting for ~70% of all such lesions. […] The incidence of SDAVF peaks in the 5th and 6th decades and males are more commonly affected than females. […] Nearly 60% of SDAVFs are spontaneous, with the remainder being caused by trauma.
  • #20 Spinal Dural Arteriovenous Fistulas | American Journal of Neuroradiology
    http://www.ajnr.org/content/30/4/639
    SDAVFs are the most frequent vascular malformation of the spine and account for approximately 70% of all vascular spinal malformations. An estimation based on the retrospective series of the major German referral center for spinal vascular diseases arrived at 510/million/year in the general population. However, the disease seems to be underdiagnosed. Usually, SDAVFs become symptomatic in elderly men. A recent meta-analysis concluded that men are affected 5 times more often than women and that the mean age at the time of diagnosis is 55-60 years. Patients younger than 30 years of age constituted less than 1% of patients with a DAVF, whereas, to our knowledge, no patient younger than 20 years of age has ever been reported. Most fistulas are solitary lesions and are found in the thoracolumbar region. In our experience, 80% of all DAVFs are located between T6 and L2. Sacral lesions occur in approximately 4% of patients, whereas high cervical lesions (at the level of the foramen magnum) occur in 2% of patients. Low cervical DAVFs (below C2 and above T1) are extremely rare. In approximately 2% of patients, double spinal DAVFs or an association of a spinal dural with a spinal pial AV shunt may be present, raising the possibility of a potential etiologic connection.
  • #21 Spinal Dural Arteriovenous Fistulas | American Journal of Neuroradiology
    http://www.ajnr.org/content/30/4/639
    SDAVFs are the most frequent vascular malformation of the spine and account for approximately 70% of all vascular spinal malformations. An estimation based on the retrospective series of the major German referral center for spinal vascular diseases arrived at 510/million/year in the general population. However, the disease seems to be underdiagnosed. Usually, SDAVFs become symptomatic in elderly men. A recent meta-analysis concluded that men are affected 5 times more often than women and that the mean age at the time of diagnosis is 55-60 years. Patients younger than 30 years of age constituted less than 1% of patients with a DAVF, whereas, to our knowledge, no patient younger than 20 years of age has ever been reported. Most fistulas are solitary lesions and are found in the thoracolumbar region. In our experience, 80% of all DAVFs are located between T6 and L2. Sacral lesions occur in approximately 4% of patients, whereas high cervical lesions (at the level of the foramen magnum) occur in 2% of patients. Low cervical DAVFs (below C2 and above T1) are extremely rare. In approximately 2% of patients, double spinal DAVFs or an association of a spinal dural with a spinal pial AV shunt may be present, raising the possibility of a potential etiologic connection.
  • #22 Spinal Dural Arteriovenous Fistulas | American Journal of Neuroradiology
    http://www.ajnr.org/content/30/4/639
    SDAVFs are the most frequent vascular malformation of the spine and account for approximately 70% of all vascular spinal malformations. An estimation based on the retrospective series of the major German referral center for spinal vascular diseases arrived at 510/million/year in the general population. However, the disease seems to be underdiagnosed. Usually, SDAVFs become symptomatic in elderly men. A recent meta-analysis concluded that men are affected 5 times more often than women and that the mean age at the time of diagnosis is 55-60 years. Patients younger than 30 years of age constituted less than 1% of patients with a DAVF, whereas, to our knowledge, no patient younger than 20 years of age has ever been reported. Most fistulas are solitary lesions and are found in the thoracolumbar region. In our experience, 80% of all DAVFs are located between T6 and L2. Sacral lesions occur in approximately 4% of patients, whereas high cervical lesions (at the level of the foramen magnum) occur in 2% of patients. Low cervical DAVFs (below C2 and above T1) are extremely rare. In approximately 2% of patients, double spinal DAVFs or an association of a spinal dural with a spinal pial AV shunt may be present, raising the possibility of a potential etiologic connection.
  • #23 Spinal Dural Arteriovenous Fistulas | American Journal of Neuroradiology
    http://www.ajnr.org/content/30/4/639
    SDAVFs are the most frequent vascular malformation of the spine and account for approximately 70% of all vascular spinal malformations. An estimation based on the retrospective series of the major German referral center for spinal vascular diseases arrived at 510/million/year in the general population. However, the disease seems to be underdiagnosed. Usually, SDAVFs become symptomatic in elderly men. A recent meta-analysis concluded that men are affected 5 times more often than women and that the mean age at the time of diagnosis is 55-60 years. Patients younger than 30 years of age constituted less than 1% of patients with a DAVF, whereas, to our knowledge, no patient younger than 20 years of age has ever been reported. Most fistulas are solitary lesions and are found in the thoracolumbar region. In our experience, 80% of all DAVFs are located between T6 and L2. Sacral lesions occur in approximately 4% of patients, whereas high cervical lesions (at the level of the foramen magnum) occur in 2% of patients. Low cervical DAVFs (below C2 and above T1) are extremely rare. In approximately 2% of patients, double spinal DAVFs or an association of a spinal dural with a spinal pial AV shunt may be present, raising the possibility of a potential etiologic connection.
  • #24 Journal of Cerebrovascular and Endovascular Neurosurgery
    https://the-jcen.org/m/journal/view.php?number=809
    The etiology of DAVFs is not fully understood, but the majority of DAVFs in adulthood appear to be acquired. […] Spinal DAVFs are reported to affect 0.5-1/100,000 per year and precise incidence of the rest of spinal vascular lesions is lacking. […] Spinal DAVFs are thought to be acquired lesions and preferentially affect middle-aged men. […] The most frequent location is in the lower thoracic and upper lumbar area and patients most commonly present with gait abnormality or lower-extremity weakness and sensory disturbances. […] Spinal DAVFs are defined by pathologic shunt between a radicular artery and coronal venous plexus of the spine without an intervening capillary bed. They are the most common type of spinal cord vascular malformation, accounting for 50% to 85% of all spinal vascular lesions.
  • #25 Arteriovenous Fistulas: The Pathological Bridge | IntechOpen
    https://www.intechopen.com/chapters/69798
    An intracranial dural arteriovenous fistula (DAVF) is a type of intracranial vascular malformation in which there is a connection between an intracranial artery and a dural venous sinus. It accounts for 1015% of all intracranial arteriovenous malformations. […] The true incidence of DAVFs is unknown. However, the reported incidence of intracranial DAVFs is approximately 1015% of all intracranial vascular abnormalities. […] DAVFs are acquired lesions; that is why they present later in life than AVMs. […] The presence of a CVD (Borden type II and III, Cognard types IIbV) or absence (Borden type I, Cognard types I, IIa) and the pattern of the venous drainage all are considered major factors by the previous classification systems and were used to assess the risk of hemorrhage or any neurologic deficits. […] In DAVFs with features predisposing to an aggressive clinical course, a more definitive treatment strategy should be adopted.
  • #26 :: KJR :: Korean Journal of Radiology
    https://www.kjronline.org/DOIx.php?id=10.3348/kjr.2015.16.5.1119
    Spinal dural arteriovenous fistula (SDAVF) is the most common spinal vascular malformation, however it is still rare and underdiagnosed. […] The exact etiology of SDAVF remains unclear. The majority of patients become symptomatic in middle age, suggesting that it is an acquired disease. Male predilection is also well known. […] Spinal dural arteriovenous fistula is rare but frequently underdiagnosed since the clinical presentations resemble other more common causes of myelopathy. The disease is treatable but can progress to serious morbidity and irreversible damage. That is, the earlier the diagnosis, the better the outcome. MR imaging and spinal angiography should be considered under high clinical suspicion. Subsequently, prompt endovascular embolization or surgical ligation should be performed according to the conditions of the patient and characteristics of the fistula. Thorough knowledge regarding SDAVF may enable clinicians and neuroradiologists to diagnose the disease in the early stages.
  • #27 Clinical characteristics and outcome of dural arteriovenous fistulas secondary to cerebral venous sinus thrombosis: a primary or secondary event? | BMC Neurology | Full Text
    https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-023-03141-6
    The Dural Arteriovenous Fistulas (DAVFs) secondary to cerebral venous sinus thrombosis (CVST) are rather rare. […] The development of DAVFs following CVST is uncommon. […] Despite there is a clear link between CVST and DAVFs. […] Most investigators believe that CVST can appear during DAVFs, CVST is a result of DAVFs. […] Nevertheless, there are also a few reports considered that DAVFs can be secondary to CVST. […] The clinical presentations are not specific and vary with the location and the venous drainage pattern of DAVFs. […] The definite diagnosis of DAVFs depends on DSA. […] The most common manifestations of DAVFs following CVST were headache and visual disturbance seen in 7 patients respectively. […] Fourteen (93.33%) patients were treated with endovascular embolization and none of the patients had permanent deficits during follow-up.
  • #28 Dural arteriovenous fistulas – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/dural-arteriovenous-fistulas/symptoms-causes/syc-20364280
    Dural arteriovenous fistulas (dAVFs) are irregular connections between arteries and veins. They occur in the tough covering over the brain or spinal cord, known as the dura mater. Dural AVFs are rare. They tend to occur between ages 50 and 60. Most often, dAVFs affect people between ages 50 and 60. But they can occur in people at younger ages, including in children. Most dural arteriovenous fistulas (dAVFs) have no clear origin. But some result from a traumatic head injury, infection, previous brain surgery, blood clots in deep veins or tumors. Risk factors of dural arteriovenous fistulas (dAVFs) include being inclined to blood clots in the vein, known as vein thrombosis. Changes in the way the blood clots may increase the risk of a blockage or narrowing of the venous sinuses. […] Research has found that noncancerous tumors found in the membranes that surround the brain and spinal cord may be associated with dAVFs.
  • #29 Dural arteriovenous fistulas – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/dural-arteriovenous-fistulas/symptoms-causes/syc-20364280
    Dural arteriovenous fistulas (dAVFs) are irregular connections between arteries and veins. They occur in the tough covering over the brain or spinal cord, known as the dura mater. Dural AVFs are rare. They tend to occur between ages 50 and 60. Most often, dAVFs affect people between ages 50 and 60. But they can occur in people at younger ages, including in children. Most dural arteriovenous fistulas (dAVFs) have no clear origin. But some result from a traumatic head injury, infection, previous brain surgery, blood clots in deep veins or tumors. Risk factors of dural arteriovenous fistulas (dAVFs) include being inclined to blood clots in the vein, known as vein thrombosis. Changes in the way the blood clots may increase the risk of a blockage or narrowing of the venous sinuses. […] Research has found that noncancerous tumors found in the membranes that surround the brain and spinal cord may be associated with dAVFs.
  • #30 Dural arteriovenous fistulas – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/dural-arteriovenous-fistulas/symptoms-causes/syc-20364280
    Dural arteriovenous fistulas (dAVFs) are irregular connections between arteries and veins. They occur in the tough covering over the brain or spinal cord, known as the dura mater. Dural AVFs are rare. They tend to occur between ages 50 and 60. Most often, dAVFs affect people between ages 50 and 60. But they can occur in people at younger ages, including in children. Most dural arteriovenous fistulas (dAVFs) have no clear origin. But some result from a traumatic head injury, infection, previous brain surgery, blood clots in deep veins or tumors. Risk factors of dural arteriovenous fistulas (dAVFs) include being inclined to blood clots in the vein, known as vein thrombosis. Changes in the way the blood clots may increase the risk of a blockage or narrowing of the venous sinuses. […] Research has found that noncancerous tumors found in the membranes that surround the brain and spinal cord may be associated with dAVFs.
  • #31 Dural arteriovenous fistulas – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/dural-arteriovenous-fistulas/symptoms-causes/syc-20364280
    Dural arteriovenous fistulas (dAVFs) are irregular connections between arteries and veins. They occur in the tough covering over the brain or spinal cord, known as the dura mater. Dural AVFs are rare. They tend to occur between ages 50 and 60. Most often, dAVFs affect people between ages 50 and 60. But they can occur in people at younger ages, including in children. Most dural arteriovenous fistulas (dAVFs) have no clear origin. But some result from a traumatic head injury, infection, previous brain surgery, blood clots in deep veins or tumors. Risk factors of dural arteriovenous fistulas (dAVFs) include being inclined to blood clots in the vein, known as vein thrombosis. Changes in the way the blood clots may increase the risk of a blockage or narrowing of the venous sinuses. […] Research has found that noncancerous tumors found in the membranes that surround the brain and spinal cord may be associated with dAVFs.
  • #32 Dural arteriovenous fistulas – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/dural-arteriovenous-fistulas/symptoms-causes/syc-20364280
    Dural arteriovenous fistulas (dAVFs) are irregular connections between arteries and veins. They occur in the tough covering over the brain or spinal cord, known as the dura mater. Dural AVFs are rare. They tend to occur between ages 50 and 60. Most often, dAVFs affect people between ages 50 and 60. But they can occur in people at younger ages, including in children. Most dural arteriovenous fistulas (dAVFs) have no clear origin. But some result from a traumatic head injury, infection, previous brain surgery, blood clots in deep veins or tumors. Risk factors of dural arteriovenous fistulas (dAVFs) include being inclined to blood clots in the vein, known as vein thrombosis. Changes in the way the blood clots may increase the risk of a blockage or narrowing of the venous sinuses. […] Research has found that noncancerous tumors found in the membranes that surround the brain and spinal cord may be associated with dAVFs.
  • #33 Dural Arteriovenous Fistulas: Epidemiology and Clinical Presentation | Neupsy Key
    https://neupsykey.com/dural-arteriovenous-fistulas-epidemiology-and-clinical-presentation/
    Dural arteriovenous fistulas (DAVFs) present at a mean age of 50 to 60 years, but individual presentation is highly heterogeneous. […] In the past, DAVFs were relatively uncommon, but are now being diagnosed with increased frequency. […] These lesions account for approximately 10% to 15% of intracranial vascular malformations. […] Among supratentorial and infratentorial vascular malformations, they account for 6% and 35% of lesions, respectively. […] These lesions seem to have no gender preponderance, but several studies have reported an increased incidence of hemorrhage in men in comparison with women. […] No linkages to family history or genetics have been identified.
  • #34
    https://scite.ai/reports/dural-arteriovenous-fistulas-epidemiology-and-2yvpLL
    Patients may also present with significant intracranial hemorrhage and neurological deficits if cortical venous hypertension is present. […] The arterial supply, venous drainage, sites of the dAVM, and clinical presentation of the cases in this series were similar to those reported in the literature with respect to infantile dAVSs. […] Interestingly, Cases 1 and 2 developed dural sinus thrombosis in early childhood prior to any intervention, which is atypical for this subtype of dAVM. […] Regardless of the actual mechanism, the key factor in the development of adult or pediatric dAVMs appears to be decreased blood flow and subsequent occlusion and shunting within the dural venous sinus. […] The presence of anomalous sigmoid sinus-IJV outflow noted in all our cases would support this hypothesis.
  • #35
    https://scite.ai/reports/dural-arteriovenous-fistulas-epidemiology-and-2yvpLL
    The resulting occlusion and venous hypertension causes dilation of capillaries, which open direct shunts between dural arteries and veins. […] We believe that the dAVMs in all 3 of our cases developed from abnormal venous sinus formation, as the lesions were already well established on initial investigation and there was no evidence of a hypercoagulable state or significant head trauma prior to presentation. […] Pediatric dural arteriovenous malformations (dAVMs) are rare lesions that have a high mortality rate and require complex management. […] Dural sinus thrombosis developed in 2 of the cases prior to any intervention, which is an unusual occurrence for this particular disease. […] All 3 cases were treated using staged endovascular embolization with a favorable outcome in 1 case and a poor outcome in the other 2 cases.
  • #36 Spinal dural arteriovenous fistula | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/spinal-dural-arteriovenous-fistula?lang=us
    Spinal dural arteriovenous fistulas (SDAVF) are the most common type of spinal vascular malformation, accounting for ~70% of all such lesions. […] The incidence of SDAVF peaks in the 5th and 6th decades and males are more commonly affected than females. […] Nearly 60% of SDAVFs are spontaneous, with the remainder being caused by trauma.
  • #37 Journal of Cerebrovascular and Endovascular Neurosurgery
    https://the-jcen.org/m/journal/view.php?number=809
    The etiology of DAVFs is not fully understood, but the majority of DAVFs in adulthood appear to be acquired. […] Spinal DAVFs are reported to affect 0.5-1/100,000 per year and precise incidence of the rest of spinal vascular lesions is lacking. […] Spinal DAVFs are thought to be acquired lesions and preferentially affect middle-aged men. […] The most frequent location is in the lower thoracic and upper lumbar area and patients most commonly present with gait abnormality or lower-extremity weakness and sensory disturbances. […] Spinal DAVFs are defined by pathologic shunt between a radicular artery and coronal venous plexus of the spine without an intervening capillary bed. They are the most common type of spinal cord vascular malformation, accounting for 50% to 85% of all spinal vascular lesions.
  • #38 Cranial Dural Arteriovenous Fistula: Diagnosis and Classification with Time-Resolved MR Angiography at 3T | American Journal of Neuroradiology
    https://www.ajnr.org/content/30/8/1546
    The diagnosis of dural arteriovenous fistula (DAVF) remains one of the few uncontested indications for catheter based cerebral angiography. […] In this small series, trMRA at 3T seems be a reliable technique in the screening and surveillance of DAVF in specific clinical situations. […] Our study evaluated the performance of a commercially available form of trMRA optimized for spatial and temporal resolution with whole-head coverage at 3T for the screening and grading of DAVFs in a population of patients in which the prevalence of a fistula was 48% (20/42). […] A reliable noninvasive imaging technique for this purpose would be welcomed. […] Our study supports the use of trMRA in the arena of cranial DAVF only for the purposes of screening and surveillance and not as a tool for complete characterization of a fistula. […] In this small series, trMRA at 3T seems to be a reliable technique in the screening and surveillance of DAVFs in specific clinical situations.
  • #39 Spinal Dural Arteriovenous Fistula: The Missing-Piece Sign | Ochsner Journal
    https://www.ochsnerjournal.org/content/22/1/10
    Spinal dural arteriovenous fistulas (sDAVFs) are a rare and often underdiagnosed spinal pathology. They occur predominantly in males in the fifth or sixth decade of life and most commonly involve the thoracolumbar region, although sDAVFs can occur anywhere along the spinal cord. Early diagnosis of sDAVFs is important; deficits are potentially reversible, but delayed treatment may result in irreversible neurologic disability. Imaging diagnosis primarily relies on magnetic resonance imaging (MRI) and conventional spinal angiography. […] sDAVFs, although a rare pathology, are the most common vascular shunts of the spine, characterized by an abnormal communication between arteries and veins within the dura. These connections are classically located within the dura mater near spinal nerve roots.
  • #40 Spinal Dural Arteriovenous Fistula: The Missing-Piece Sign | Ochsner Journal
    https://www.ochsnerjournal.org/content/22/1/10
    Spinal dural arteriovenous fistulas (sDAVFs) are a rare and often underdiagnosed spinal pathology. They occur predominantly in males in the fifth or sixth decade of life and most commonly involve the thoracolumbar region, although sDAVFs can occur anywhere along the spinal cord. Early diagnosis of sDAVFs is important; deficits are potentially reversible, but delayed treatment may result in irreversible neurologic disability. Imaging diagnosis primarily relies on magnetic resonance imaging (MRI) and conventional spinal angiography. […] sDAVFs, although a rare pathology, are the most common vascular shunts of the spine, characterized by an abnormal communication between arteries and veins within the dura. These connections are classically located within the dura mater near spinal nerve roots.
  • #41 Cranial Dural Arteriovenous Fistula: Diagnosis and Classification with Time-Resolved MR Angiography at 3T | American Journal of Neuroradiology
    https://www.ajnr.org/content/30/8/1546
    The diagnosis of dural arteriovenous fistula (DAVF) remains one of the few uncontested indications for catheter based cerebral angiography. […] In this small series, trMRA at 3T seems be a reliable technique in the screening and surveillance of DAVF in specific clinical situations. […] Our study evaluated the performance of a commercially available form of trMRA optimized for spatial and temporal resolution with whole-head coverage at 3T for the screening and grading of DAVFs in a population of patients in which the prevalence of a fistula was 48% (20/42). […] A reliable noninvasive imaging technique for this purpose would be welcomed. […] Our study supports the use of trMRA in the arena of cranial DAVF only for the purposes of screening and surveillance and not as a tool for complete characterization of a fistula. […] In this small series, trMRA at 3T seems to be a reliable technique in the screening and surveillance of DAVFs in specific clinical situations.
  • #42 Spinal Dural Arteriovenous Fistulas | American Journal of Neuroradiology
    http://www.ajnr.org/content/30/4/639
    Despite being the most commonly encountered spinal vascular malformation, spinal dural arteriovenous fistulas (SDAVFs) are rare and still underdiagnosed entities, which, if not treated properly, can lead to considerable morbidity with progressive spinal cord symptoms. Because presenting clinical symptoms are unspecific, the neuroradiologist is often the first clinician to raise the possibility of this diagnosis, which initially rests mainly on MR imaging. For a thorough understanding of the disease and for planning the therapeutic strategy, however, selective spinal digital subtraction angiography (DSA) still is necessary. The aim of the following article is to review the epidemiology, etiology, clinical and imaging features, and therapeutic approaches of this type of spinal vascular malformation.
  • #43 Cranial Dural Arteriovenous Fistula: Diagnosis and Classification with Time-Resolved MR Angiography at 3T | American Journal of Neuroradiology
    https://www.ajnr.org/content/30/8/1546
    The diagnosis of dural arteriovenous fistula (DAVF) remains one of the few uncontested indications for catheter based cerebral angiography. […] In this small series, trMRA at 3T seems be a reliable technique in the screening and surveillance of DAVF in specific clinical situations. […] Our study evaluated the performance of a commercially available form of trMRA optimized for spatial and temporal resolution with whole-head coverage at 3T for the screening and grading of DAVFs in a population of patients in which the prevalence of a fistula was 48% (20/42). […] A reliable noninvasive imaging technique for this purpose would be welcomed. […] Our study supports the use of trMRA in the arena of cranial DAVF only for the purposes of screening and surveillance and not as a tool for complete characterization of a fistula. […] In this small series, trMRA at 3T seems to be a reliable technique in the screening and surveillance of DAVFs in specific clinical situations.
  • #44 Clinical characteristics and outcome of dural arteriovenous fistulas secondary to cerebral venous sinus thrombosis: a primary or secondary event? | BMC Neurology | Full Text
    https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-023-03141-6
    Continued observation and follow-up of (DSA) are important to find DAVFs secondary to CVST. […] DAVFs could be a rare chronic consequence of CVST. […] Most patients with DAVFs have a good outcome after timely interventional therapy. […] Therefore, continued clinical observation and follow-up of DSA is important to find whether DAVFs occur.
  • #45 Clinical characteristics and outcome of dural arteriovenous fistulas secondary to cerebral venous sinus thrombosis: a primary or secondary event? | BMC Neurology | Full Text
    https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-023-03141-6
    The Dural Arteriovenous Fistulas (DAVFs) secondary to cerebral venous sinus thrombosis (CVST) are rather rare. […] The development of DAVFs following CVST is uncommon. […] Despite there is a clear link between CVST and DAVFs. […] Most investigators believe that CVST can appear during DAVFs, CVST is a result of DAVFs. […] Nevertheless, there are also a few reports considered that DAVFs can be secondary to CVST. […] The clinical presentations are not specific and vary with the location and the venous drainage pattern of DAVFs. […] The definite diagnosis of DAVFs depends on DSA. […] The most common manifestations of DAVFs following CVST were headache and visual disturbance seen in 7 patients respectively. […] Fourteen (93.33%) patients were treated with endovascular embolization and none of the patients had permanent deficits during follow-up.
  • #46 Spinal Dural Arteriovenous Fistula: The Missing-Piece Sign | Ochsner Journal
    https://www.ochsnerjournal.org/content/22/1/10
    Management strategies include conservative management with surveillance imaging, endovascular embolization, and surgical ligation. Conservative management may be appropriate for asymptomatic sDAVFs, but close clinical and imaging surveillance is necessary because of the risk of progression to symptomatic lesions. […] Once lesions are symptomatic, the natural clinical course is gradual worsening with the potential for irreversible spinal cord injury, and early treatment should be considered to alleviate patient symptoms and to mitigate clinical deterioration.
  • #47 Cranial Dural Arteriovenous Fistula: Diagnosis and Classification with Time-Resolved MR Angiography at 3T | American Journal of Neuroradiology
    https://www.ajnr.org/content/30/8/1546
    The diagnosis of dural arteriovenous fistula (DAVF) remains one of the few uncontested indications for catheter based cerebral angiography. […] In this small series, trMRA at 3T seems be a reliable technique in the screening and surveillance of DAVF in specific clinical situations. […] Our study evaluated the performance of a commercially available form of trMRA optimized for spatial and temporal resolution with whole-head coverage at 3T for the screening and grading of DAVFs in a population of patients in which the prevalence of a fistula was 48% (20/42). […] A reliable noninvasive imaging technique for this purpose would be welcomed. […] Our study supports the use of trMRA in the arena of cranial DAVF only for the purposes of screening and surveillance and not as a tool for complete characterization of a fistula. […] In this small series, trMRA at 3T seems to be a reliable technique in the screening and surveillance of DAVFs in specific clinical situations.
  • #48 Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): rationale, design, and initial characterization of patient cohort in: Journal of Neurosurgery Volume 136 Issue 4 (2021) Journals
    https://thejns.org/view/journals/j-neurosurg/136/4/article-p951.xml
    Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. […] CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. […] With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
  • #49 Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): rationale, design, and initial characterization of patient cohort in: Journal of Neurosurgery Volume 136 Issue 4 (2021) Journals
    https://thejns.org/view/journals/j-neurosurg/136/4/article-p951.xml
    Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. […] CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. […] With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
  • #50 Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): rationale, design, and initial characterization of patient cohort in: Journal of Neurosurgery Volume 136 Issue 4 (2021) Journals
    https://thejns.org/view/journals/j-neurosurg/136/4/article-p951.xml
    Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. […] CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. […] With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
  • #51 Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): rationale, design, and initial characterization of patient cohort in: Journal of Neurosurgery Volume 136 Issue 4 (2021) Journals
    https://thejns.org/view/journals/j-neurosurg/136/4/article-p951.xml
    Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. […] CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. […] With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
  • #52 Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): rationale, design, and initial characterization of patient cohort in: Journal of Neurosurgery Volume 136 Issue 4 (2021) Journals
    https://thejns.org/view/journals/j-neurosurg/136/4/article-p951.xml
    Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. […] CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. […] With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
  • #53 Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): rationale, design, and initial characterization of patient cohort in: Journal of Neurosurgery Volume 136 Issue 4 (2021) Journals
    https://thejns.org/view/journals/j-neurosurg/136/4/article-p951.xml
    Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. […] CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. […] With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
  • #54 Dural Arteriovenous Fistula Manifested as Rapid Progressive Dementia Successfully Treated by Endovascular Embolization Only
    https://neurointervention.org/journal/view.php?number=138
    A dural arteriovenous fistula (DAVF) is an uncommon type of intracranial vascular malformation. Though the true incidence of DAVF is unknown, the reported incidence is approximately 10-15% of all intracranial vascular malformations. […] However, there have been little reports about DAVFs manifested as rapidly progressive dementia. […] This case is atypical since usually a tentorial DAVF with cortical venous drainage tends to offend the bilateral thalami and cause dementia. […] Therefore, early intervention through surgery or endovascular embolization is important. […] As a conclusion, thalamic dementia caused by a DAVF located in posterior fossa is rare, but delayed recognition of its presence could cause irreversible ischemic damage of the thalamus. So evaluation of a DAVF located in the posterior fossa in patients showing thalamic dementia is important.
  • #55 Journal of Cerebrovascular and Endovascular Neurosurgery
    https://the-jcen.org/m/journal/view.php?number=809
    The etiology of DAVFs is not fully understood, but the majority of DAVFs in adulthood appear to be acquired. […] Spinal DAVFs are reported to affect 0.5-1/100,000 per year and precise incidence of the rest of spinal vascular lesions is lacking. […] Spinal DAVFs are thought to be acquired lesions and preferentially affect middle-aged men. […] The most frequent location is in the lower thoracic and upper lumbar area and patients most commonly present with gait abnormality or lower-extremity weakness and sensory disturbances. […] Spinal DAVFs are defined by pathologic shunt between a radicular artery and coronal venous plexus of the spine without an intervening capillary bed. They are the most common type of spinal cord vascular malformation, accounting for 50% to 85% of all spinal vascular lesions.
  • #56
    https://link.springer.com/article/10.1007/s10143-017-0929-6
    Arterial aneurysms are uncommon among patients with dural arteriovenous fistulae (DAVFs), and there is limited information available to guide treatment decisions in such cases. […] The purpose of our study was to clarify epidemiology, natural history, and management of these lesions. A total of 43 published cases of DAVF associated aneurysms were found in 26 studies on the topic. Anterior cranial fossa was the most common location (40%), and ethmoidal branches were the most common arterial feeders (55%). […] Approximately 10% of intracranial DAVFs were associated with aneurysms located in the intraorbital OA. Overall, 70% of lesions were Borden type III, and 50% of patients presented with hemorrhage. […] DAVF associated aneurysms are fairly rare. Anterior cranial fossa location and direct cortical venous drainage are common among these lesions. The aneurysms are less likely to be located on feeding arteries, and hemorrhagic presentation related to flow-related aneurysm rupture is uncommon.
  • #57 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #58 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #59 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #60 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #61 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #62 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #63 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #64 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #65 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #66 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #67 Arteriovenous Fistulas: The Pathological Bridge | IntechOpen
    https://www.intechopen.com/chapters/69798
    An intracranial dural arteriovenous fistula (DAVF) is a type of intracranial vascular malformation in which there is a connection between an intracranial artery and a dural venous sinus. It accounts for 1015% of all intracranial arteriovenous malformations. […] The true incidence of DAVFs is unknown. However, the reported incidence of intracranial DAVFs is approximately 1015% of all intracranial vascular abnormalities. […] DAVFs are acquired lesions; that is why they present later in life than AVMs. […] The presence of a CVD (Borden type II and III, Cognard types IIbV) or absence (Borden type I, Cognard types I, IIa) and the pattern of the venous drainage all are considered major factors by the previous classification systems and were used to assess the risk of hemorrhage or any neurologic deficits. […] In DAVFs with features predisposing to an aggressive clinical course, a more definitive treatment strategy should be adopted.
  • #68 Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): rationale, design, and initial characterization of patient cohort in: Journal of Neurosurgery Volume 136 Issue 4 (2021) Journals
    https://thejns.org/view/journals/j-neurosurg/136/4/article-p951.xml
    Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. […] CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. […] With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
  • #69 Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): rationale, design, and initial characterization of patient cohort in: Journal of Neurosurgery Volume 136 Issue 4 (2021) Journals
    https://thejns.org/view/journals/j-neurosurg/136/4/article-p951.xml
    Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. […] CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. […] With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.
  • #70 Dural Arteriovenous Fistula (dAVF): Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/dural-arteriovenous-fistula-davf
    A dural arteriovenous fistula (dAVF) is an abnormal connection between an artery and vein within the protective tissue that surrounds your brain and spinal cord. […] In the United States, a dural arteriovenous fistula affects an estimated 0.15 to 0.19 out of 100,000 people each year. […] Some dural arteriovenous fistulas are mild and wont cause a major health complication, while others are very serious and can be life-threatening. […] A dural arteriovenous fistula can affect anyone at any age. The condition is most common among adults between ages 40 and 60. […] Complications of dAVF can be life-threatening and may include: Bleeding within your brain tissue (hemorrhage). […] Your prognosis depends on many factors, like the location of the fistula and whether bleeding has occurred. With early discovery and treatment, your prognosis is positive. Unfortunately, some dural arteriovenous fistulas can lead to permanent or life-threatening complications. […] Current studies report that the annual mortality rate (the number of people who die due to this condition) is between 11% and 19%. This estimates the annual survival rate to be above 80% in certain cases.
  • #71 Dural Arteriovenous Fistula (dAVF): Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/dural-arteriovenous-fistula-davf
    A dural arteriovenous fistula (dAVF) is an abnormal connection between an artery and vein within the protective tissue that surrounds your brain and spinal cord. […] In the United States, a dural arteriovenous fistula affects an estimated 0.15 to 0.19 out of 100,000 people each year. […] Some dural arteriovenous fistulas are mild and wont cause a major health complication, while others are very serious and can be life-threatening. […] A dural arteriovenous fistula can affect anyone at any age. The condition is most common among adults between ages 40 and 60. […] Complications of dAVF can be life-threatening and may include: Bleeding within your brain tissue (hemorrhage). […] Your prognosis depends on many factors, like the location of the fistula and whether bleeding has occurred. With early discovery and treatment, your prognosis is positive. Unfortunately, some dural arteriovenous fistulas can lead to permanent or life-threatening complications. […] Current studies report that the annual mortality rate (the number of people who die due to this condition) is between 11% and 19%. This estimates the annual survival rate to be above 80% in certain cases.
  • #72 Dural Arteriovenous Fistula (dAVF): Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/dural-arteriovenous-fistula-davf
    A dural arteriovenous fistula (dAVF) is an abnormal connection between an artery and vein within the protective tissue that surrounds your brain and spinal cord. […] In the United States, a dural arteriovenous fistula affects an estimated 0.15 to 0.19 out of 100,000 people each year. […] Some dural arteriovenous fistulas are mild and wont cause a major health complication, while others are very serious and can be life-threatening. […] A dural arteriovenous fistula can affect anyone at any age. The condition is most common among adults between ages 40 and 60. […] Complications of dAVF can be life-threatening and may include: Bleeding within your brain tissue (hemorrhage). […] Your prognosis depends on many factors, like the location of the fistula and whether bleeding has occurred. With early discovery and treatment, your prognosis is positive. Unfortunately, some dural arteriovenous fistulas can lead to permanent or life-threatening complications. […] Current studies report that the annual mortality rate (the number of people who die due to this condition) is between 11% and 19%. This estimates the annual survival rate to be above 80% in certain cases.
  • #73 Dural Arteriovenous Fistula (dAVF): Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/dural-arteriovenous-fistula-davf
    A dural arteriovenous fistula (dAVF) is an abnormal connection between an artery and vein within the protective tissue that surrounds your brain and spinal cord. […] In the United States, a dural arteriovenous fistula affects an estimated 0.15 to 0.19 out of 100,000 people each year. […] Some dural arteriovenous fistulas are mild and wont cause a major health complication, while others are very serious and can be life-threatening. […] A dural arteriovenous fistula can affect anyone at any age. The condition is most common among adults between ages 40 and 60. […] Complications of dAVF can be life-threatening and may include: Bleeding within your brain tissue (hemorrhage). […] Your prognosis depends on many factors, like the location of the fistula and whether bleeding has occurred. With early discovery and treatment, your prognosis is positive. Unfortunately, some dural arteriovenous fistulas can lead to permanent or life-threatening complications. […] Current studies report that the annual mortality rate (the number of people who die due to this condition) is between 11% and 19%. This estimates the annual survival rate to be above 80% in certain cases.
  • #74 A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas in: Journal of Neurosurgery Volume 129 Issue 5 (2017) Journals
    https://thejns.org/view/journals/j-neurosurg/129/5/article-p1114.xml
    The rarity of cerebral dural arteriovenous fistulas (dAVFs) has precluded analysis of their natural history across large cohorts. […] In the present study, the authors exclusively evaluated the untreated course of dAVFs across a multi-institutional data set to delineate demographic, angiographic, and natural history data. […] Two hundred ninety-five dAVFs had at least 1 month of untreated follow-up. […] The respective annualized NHND and hemorrhage rates were 2.3% and 2.9% for asymptomatic Type IIIV dAVFs, 23.1% and 3.3% for dAVFs presenting with NHND, and 0% and 46.2% for lesions presenting with hemorrhage. […] On multivariate analysis, NHND presentation (HR 11.49, 95% CI 3.1963) and leptomeningeal venous drainage (HR 5.03, 95% CI 0.42694) were significant risk factors for NHND; hemorrhagic presentation (HR 17.67, 95% CI 2.99117) and leptomeningeal venous drainage (HR 10.39, 95% CI 1.111384) were significant risk factors for hemorrhage. […] All Type IIIV dAVFs should be considered for treatment. Given the high risk of rebleeding, lesions presenting with NHND and/or hemorrhage should be treated expediently.
  • #75 Spinal Dural Arteriovenous Fistula: The Missing-Piece Sign | Ochsner Journal
    https://www.ochsnerjournal.org/content/22/1/10
    Spinal dural arteriovenous fistulas (sDAVFs) are a rare and often underdiagnosed spinal pathology. They occur predominantly in males in the fifth or sixth decade of life and most commonly involve the thoracolumbar region, although sDAVFs can occur anywhere along the spinal cord. Early diagnosis of sDAVFs is important; deficits are potentially reversible, but delayed treatment may result in irreversible neurologic disability. Imaging diagnosis primarily relies on magnetic resonance imaging (MRI) and conventional spinal angiography. […] sDAVFs, although a rare pathology, are the most common vascular shunts of the spine, characterized by an abnormal communication between arteries and veins within the dura. These connections are classically located within the dura mater near spinal nerve roots.
  • #76 Spinal Dural Arteriovenous Fistula: The Missing-Piece Sign | Ochsner Journal
    https://www.ochsnerjournal.org/content/22/1/10
    Management strategies include conservative management with surveillance imaging, endovascular embolization, and surgical ligation. Conservative management may be appropriate for asymptomatic sDAVFs, but close clinical and imaging surveillance is necessary because of the risk of progression to symptomatic lesions. […] Once lesions are symptomatic, the natural clinical course is gradual worsening with the potential for irreversible spinal cord injury, and early treatment should be considered to alleviate patient symptoms and to mitigate clinical deterioration.
  • #77 Paediatric intracranial dural arteriovenous fistulas: clinical characteristics, treatment outcomes and prognosis | Stroke and Vascular Neurology
    https://svn.bmj.com/content/early/2024/06/05/svn-2024-003122
    Paediatric dural arteriovenous fistulas (DAVFs) are notable for their rarity, distinct clinical manifestations, low cure rate and poor prognosis in some case series or reports. […] The long-term follow-up results indicate that infantile-type DAVFs has a poorer prognosis. It is extremely necessary to closely monitor them in the long term. […] Most adult-type DAVFs and DSMs can now be effectively treated with embolisation, resulting in good outcomes and prognosis. However, there are still challenges in treating infantile-type DAVFs, and the prognosis is frequently poor. […] Paediatric DAVFs are notable for their rarity, distinct clinical manifestations, low cure rate and poor prognosis. Most adult-type DAVFs and DSMs can now be effectively treated with embolisation, resulting in good outcomes and prognosis. However, there are still challenges in treating infantile-type DAVFs, and the prognosis is frequently poor.
  • #78 Paediatric intracranial dural arteriovenous fistulas: clinical characteristics, treatment outcomes and prognosis | Stroke and Vascular Neurology
    https://svn.bmj.com/content/early/2024/06/05/svn-2024-003122
    Paediatric dural arteriovenous fistulas (DAVFs) are notable for their rarity, distinct clinical manifestations, low cure rate and poor prognosis in some case series or reports. […] The long-term follow-up results indicate that infantile-type DAVFs has a poorer prognosis. It is extremely necessary to closely monitor them in the long term. […] Most adult-type DAVFs and DSMs can now be effectively treated with embolisation, resulting in good outcomes and prognosis. However, there are still challenges in treating infantile-type DAVFs, and the prognosis is frequently poor. […] Paediatric DAVFs are notable for their rarity, distinct clinical manifestations, low cure rate and poor prognosis. Most adult-type DAVFs and DSMs can now be effectively treated with embolisation, resulting in good outcomes and prognosis. However, there are still challenges in treating infantile-type DAVFs, and the prognosis is frequently poor.
  • #79 Paediatric intracranial dural arteriovenous fistulas: clinical characteristics, treatment outcomes and prognosis | Stroke and Vascular Neurology
    https://svn.bmj.com/content/early/2024/06/05/svn-2024-003122
    Paediatric dural arteriovenous fistulas (DAVFs) are notable for their rarity, distinct clinical manifestations, low cure rate and poor prognosis in some case series or reports. […] The long-term follow-up results indicate that infantile-type DAVFs has a poorer prognosis. It is extremely necessary to closely monitor them in the long term. […] Most adult-type DAVFs and DSMs can now be effectively treated with embolisation, resulting in good outcomes and prognosis. However, there are still challenges in treating infantile-type DAVFs, and the prognosis is frequently poor. […] Paediatric DAVFs are notable for their rarity, distinct clinical manifestations, low cure rate and poor prognosis. Most adult-type DAVFs and DSMs can now be effectively treated with embolisation, resulting in good outcomes and prognosis. However, there are still challenges in treating infantile-type DAVFs, and the prognosis is frequently poor.