Transvenous embolization for cavernous dural arteriovenous shunts

About the intracranial venous approach to the cavernous sinus

Kimihiro Yoshino, Takao Yasuhara, Noboru Kusaka, Minoru Nakagawa, Yoshinori Terai, Shunichiro Fujimoto

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish
Pages (from-to)639-645
Number of pages7
JournalNeurological Surgery
Volume28
Issue number7
Publication statusPublished - Jul 2000
Externally publishedYes

Fingerprint

Cavernous Sinus
Veins
Drainage
Craniotomy
Cerebral Veins
Consciousness
Seizures
Therapeutics

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 journalArticle

Yoshino, Kimihiro ; Yasuhara, Takao ; Kusaka, Noboru ; Nakagawa, Minoru ; Terai, Yoshinori ; Fujimoto, Shunichiro. / Transvenous embolization for cavernous dural arteriovenous shunts : About the intracranial venous approach to the cavernous sinus. In: Neurological Surgery. 2000 ; Vol. 28, No. 7. pp. 639-645.
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