Long-term changes in intracranial dural arteriovenous fistulae leading to worsening in the type of venous drainage

• Published in: Neuroradiology Vol. 39; no. 1; pp. 59 - 66
• Main Authors: COGNARD, C, HOUDART, E, CASASCO, A, GABRILLARGUES, J, CHIRAS, J, MERLAND, J. J
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.01.1997
• Subjects: Adult; Aged; Arteriovenous Fistula - diagnostic imaging; Arteriovenous Fistula - physiopathology; Biological and medical sciences; Cerebral Angiography; Cerebral Arteries - diagnostic imaging; Cerebral Arteries - physiopathology; Cerebral Veins - diagnostic imaging; Cerebral Veins - physiopathology; Disease Progression; Female; Follow-Up Studies; Humans; Intracranial Arteriovenous Malformations - diagnostic imaging; Intracranial Arteriovenous Malformations - physiopathology; Male; Medical sciences; Middle Aged; Neurology; Risk Factors; Thrombophlebitis - etiology; Vascular diseases and vascular malformations of the nervous system; Human; Intracranial; Nervous system diseases; Radiodiagnosis; Angiography; Cardiovascular disease; Congenital disease; Long term; Cerebral disorder; Vascular disease; Central nervous system disease; Dura mater; Evolution; Cerebrovascular disease; Arteriovenous malformation
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s002340050368

We review seven patients with intracranial dural arteriovenous fistulae (ICDAVF), each altering the initial type of venous drainage to one with a higher grading during long-term follow-up. Five were discovered due to symptoms of intracranial hypertension, two due to changes in tinnitus and one case following subarachnoid haemorrhage. In five cases, cortical venous drainage developed during the follow-up period. Three different mechanisms were observed: stenosis or thrombosis in the draining veins in 4 cases: increased arterial flow in 2; and the appearance o a new fistula site or extension of the initial shunt in 2. Type I and type II a fistulae which are not completely cured, require both close clinical observation and Doppler examinations in the follow-up period. Any charge in the clinical pictures indicates a repeat angiogram. Stenosis of the venous drain-age, forecasting later worsening in the venous outlet, requires more thorough angiographic follow-up.