OBJECT: In this paper the authors' goal was to review the clinical features and outcome of patients with intracranial dural arteriovenous fistulas (DAVFs) who presented with hemorrhage. METHODS: A retrospective study of 28 patients with DAVFs who presented with intracranial hemorrhage to 2 separate institutions was performed. The information reviewed included clinical presentation, location and size of hemorrhage, angiographic features, treatment, and clinical and radiologically documented outcomes. Clinical and radiological follow-up were available in 27 of 28 patients (mean follow-up 17 months). RESULTS: The vast majority of patients were male (86%), and the most common presenting symptom was sudden-onset headache. All DAVFs had cortical venous drainage, and about one-third were associated with a venous varix. The most common location was tentorial (75%). Treatment ranged from endovascular (71%), surgical (43%), Gamma Knife surgery (4%), or a combination of modalities. The majority of fistulas (75%) were completely obliterated, and most patients experienced excellent clinical outcome (71%, modified Rankin Scale score of 0 or 1). There were no complications in this series. CONCLUSIONS: Case series, including the current one, suggest that the vast majority of patients who present with intracranial hemorrhage from a DAVF are male. The most common location for DAVFs presenting with hemorrhage is tentorial. Excellent outcomes are achieved with individualized treatment, which includes various therapeutic strategies alone or in combination. Despite the hemorrhagic presentation, almost two-thirds of patients experience a full recovery with no or minimal residual symptoms.
OBJECT: In this paper the authors' goal was to review the clinical features and outcome of patients with intracranial dural arteriovenous fistulas (DAVFs) who presented with hemorrhage. METHODS: A retrospective study of 28 patients with DAVFs who presented with intracranial hemorrhage to 2 separate institutions was performed. The information reviewed included clinical presentation, location and size of hemorrhage, angiographic features, treatment, and clinical and radiologically documented outcomes. Clinical and radiological follow-up were available in 27 of 28 patients (mean follow-up 17 months). RESULTS: The vast majority of patients were male (86%), and the most common presenting symptom was sudden-onset headache. All DAVFs had cortical venous drainage, and about one-third were associated with a venous varix. The most common location was tentorial (75%). Treatment ranged from endovascular (71%), surgical (43%), Gamma Knife surgery (4%), or a combination of modalities. The majority of fistulas (75%) were completely obliterated, and most patients experienced excellent clinical outcome (71%, modified Rankin Scale score of 0 or 1). There were no complications in this series. CONCLUSIONS: Case series, including the current one, suggest that the vast majority of patients who present with intracranial hemorrhage from a DAVF are male. The most common location for DAVFs presenting with hemorrhage is tentorial. Excellent outcomes are achieved with individualized treatment, which includes various therapeutic strategies alone or in combination. Despite the hemorrhagic presentation, almost two-thirds of patients experience a full recovery with no or minimal residual symptoms.
Authors: Andrew J Durnford; Danyal Akarca; David Culliford; John Millar; Ridhima Guniganti; Enrico Giordan; Waleed Brinjikji; Ching-Jen Chen; Isaac Josh Abecassis; Michael Levitt; Adam J Polifka; Colin P Derdeyn; Edgar A Samaniego; Amanda Kwasnicki; Ali Alaraj; Adriaan R E Potgieser; Stephanie Chen; Yoshiteru Tada; Ryan Phelps; Adib Abla; Junichiro Satomi; Robert M Starke; J Marc C van Dijk; Sepideh Amin-Hanjani; Minako Hayakawa; Bradley Gross; W Christopher Fox; Louis Kim; Jason Sheehan; Giuseppe Lanzino; Akash P Kansagra; Rose Du; Rosalind Lai; Gregory J Zipfel; Diederik O Bulters Journal: Stroke Date: 2022-04-14 Impact factor: 10.170
Authors: W M T Jolink; J M C van Dijk; C J J van Asch; G A P de Kort; A Algra; R J M Groen; G J E Rinkel; C J M Klijn Journal: J Neurol Date: 2015-09-26 Impact factor: 4.849