Abstract
Recently, the first choice of therapy for cavernous dural arteriovenous shunts (CdAVS) is transvenous embolization. Usually the approach routes for cavernous sinus are the inferior petrosal sinus (IPS), the superior ophthalmic vein (SOV) in most cases and the superior petrosal sinus (SPS) in rare case. But, it is difficult for us to treat patients in whom there are no extracranial veins through which to approach the cavernous sinus, with transvenous embolization. We presented the case in which intracranial transvenous approach to the cavernous sinus and transvenous embolization were performed and in which we achieve good results. In this article, we presented a case with Barrow's type D CdAVS and cortical venous drainage. At first, transarterial embolization was performed to decrease the amount of venous drainage for the purpose of eliminate convulsions and consciousness disturbance. However, cortical venous drainage continued. Moreover bilateral dilated SOVs normalized and bilateral IPSs were not visible, so we decided that it was impossible to carry out the transvenous embolization via extracranial veins. Transvenous embolization to the left cavernous sinus via the intracranial ophthalmic vein between the superior ophthalmic fissure and the inferior ophthalmic fissure after craniotomy was performed. Then, the transvenous embolization to the right cavernous sinus was carried out through the right Superficial middle cerebral vein after craniotomy. The results were good and chemosis and bilateral abducens palsy diminished immediately. Trans- intracranial venous embolizition for CdAVS is a very useful therapy when no extracranial veins exist for transvenous embolization.
| Original language | English |
|---|---|
| Pages (from-to) | 639-645 |
| Number of pages | 7 |
| Journal | Neurological Surgery |
| Volume | 28 |
| Issue number | 7 |
| Publication status | Published - Jul 2000 |
| Externally published | Yes |
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Keywords
- Cavernous dural arteriovenous shunts
- Intracraniai venous approach
- Transvenous embolization
ASJC Scopus subject areas
- Clinical Neurology
Cite this
Transvenous embolization for cavernous dural arteriovenous shunts : About the intracranial venous approach to the cavernous sinus. / Yoshino, Kimihiro; Yasuhara, Takao; Kusaka, Noboru; Nakagawa, Minoru; Terai, Yoshinori; Fujimoto, Shunichiro.
In: Neurological Surgery, Vol. 28, No. 7, 07.2000, p. 639-645.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Transvenous embolization for cavernous dural arteriovenous shunts
T2 - About the intracranial venous approach to the cavernous sinus
AU - Yoshino, Kimihiro
AU - Yasuhara, Takao
AU - Kusaka, Noboru
AU - Nakagawa, Minoru
AU - Terai, Yoshinori
AU - Fujimoto, Shunichiro
PY - 2000/7
Y1 - 2000/7
N2 - Recently, the first choice of therapy for cavernous dural arteriovenous shunts (CdAVS) is transvenous embolization. Usually the approach routes for cavernous sinus are the inferior petrosal sinus (IPS), the superior ophthalmic vein (SOV) in most cases and the superior petrosal sinus (SPS) in rare case. But, it is difficult for us to treat patients in whom there are no extracranial veins through which to approach the cavernous sinus, with transvenous embolization. We presented the case in which intracranial transvenous approach to the cavernous sinus and transvenous embolization were performed and in which we achieve good results. In this article, we presented a case with Barrow's type D CdAVS and cortical venous drainage. At first, transarterial embolization was performed to decrease the amount of venous drainage for the purpose of eliminate convulsions and consciousness disturbance. However, cortical venous drainage continued. Moreover bilateral dilated SOVs normalized and bilateral IPSs were not visible, so we decided that it was impossible to carry out the transvenous embolization via extracranial veins. Transvenous embolization to the left cavernous sinus via the intracranial ophthalmic vein between the superior ophthalmic fissure and the inferior ophthalmic fissure after craniotomy was performed. Then, the transvenous embolization to the right cavernous sinus was carried out through the right Superficial middle cerebral vein after craniotomy. The results were good and chemosis and bilateral abducens palsy diminished immediately. Trans- intracranial venous embolizition for CdAVS is a very useful therapy when no extracranial veins exist for transvenous embolization.
AB - Recently, the first choice of therapy for cavernous dural arteriovenous shunts (CdAVS) is transvenous embolization. Usually the approach routes for cavernous sinus are the inferior petrosal sinus (IPS), the superior ophthalmic vein (SOV) in most cases and the superior petrosal sinus (SPS) in rare case. But, it is difficult for us to treat patients in whom there are no extracranial veins through which to approach the cavernous sinus, with transvenous embolization. We presented the case in which intracranial transvenous approach to the cavernous sinus and transvenous embolization were performed and in which we achieve good results. In this article, we presented a case with Barrow's type D CdAVS and cortical venous drainage. At first, transarterial embolization was performed to decrease the amount of venous drainage for the purpose of eliminate convulsions and consciousness disturbance. However, cortical venous drainage continued. Moreover bilateral dilated SOVs normalized and bilateral IPSs were not visible, so we decided that it was impossible to carry out the transvenous embolization via extracranial veins. Transvenous embolization to the left cavernous sinus via the intracranial ophthalmic vein between the superior ophthalmic fissure and the inferior ophthalmic fissure after craniotomy was performed. Then, the transvenous embolization to the right cavernous sinus was carried out through the right Superficial middle cerebral vein after craniotomy. The results were good and chemosis and bilateral abducens palsy diminished immediately. Trans- intracranial venous embolizition for CdAVS is a very useful therapy when no extracranial veins exist for transvenous embolization.
KW - Cavernous dural arteriovenous shunts
KW - Intracraniai venous approach
KW - Transvenous embolization
UR - http://www.scopus.com/inward/record.url?scp=0033930589&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033930589&partnerID=8YFLogxK
M3 - Article
VL - 28
SP - 639
EP - 645
JO - Neurological Surgery
JF - Neurological Surgery
SN - 0301-2603
IS - 7
ER -