Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China.
Department of Radiology, The First Hospital of Jilin University, Changchun, 130021, China.
Int J Med Sci. 2019 Jan 1;16(2):203-211. doi: 10.7150/ijms.29637. eCollection 2019.
Anterior cranial fossa (ACF) dural arteriovenous fistulae (DAVFs) are rare, and a systematic review of the literature is lacking. Such a review is necessary, however, so a systematic PubMed search of related studies was performed. Twenty-four studies were identified, reporting on 48 patients, of whom 39 had definite age and sex information and 33 (84.6%, 33/39) were male. The afflicted patients were between 37 and 80 years old (mean 55.6). Among the 48 patients, 28 (58.3%, 28/48) primarily presented with intracranial hemorrhage, 47 (97.9%, 47/48) had feeding arteries from the anterior ethmoidal artery (AEA) of the ophthalmic artery (OA), and 40 (83.3%, 40/48) had bilateral feeding arteries. All of the cases had high-grade Cognard classifications (III-IV). Among the 48 patients, 43 (89.6%, 43/48) had drainage into the superior sagittal sinus (SSS). In addition, 36 (75%, 36/48) patients were treated via transarterial embolization (TAE). Of these patients, 28 (77.8%, 28/36) were managed via the AEA of the OA. Another 12 (25%, 12/48) patients were treated via transvenous embolization (TVE), 11 of whom (91.7%, 11/12) were treated with the trans-SSS approach. Complete angiographic cure was achieved in 44 (91.7%, 44/48) patients, with 4 (8.3%, 4/48) patients suffering from postprocedural complications. All 48 patients had clear descriptions of follow-up outcomes, with 45 (93.8%, 45/48) patients having a good outcome. Thus, when treating ACF DAVFs, endovascular treatment (EVT) can completely obliterate the fistula point and correct the venous shunting. EVT is therefore an effective treatment for ACF DAVF. Although many complications can occur, this approach achieves good outcomes in most cases.
前颅窝 (ACF) 硬脑膜动静脉瘘 (DAVF) 较为罕见，目前缺乏对其的系统综述。因此，有必要进行系统的文献检索。本文对相关研究进行了系统的 PubMed 检索，共确定了 24 项研究，报道了 48 例患者，其中 39 例有明确的年龄和性别信息，33 例（84.6%，33/39）为男性。患者年龄 37 至 80 岁（平均 55.6 岁）。48 例患者中，28 例（58.3%，28/48）主要表现为颅内出血，47 例（97.9%，47/48）供血动脉来自眼动脉（OA）的筛前动脉（AEA），40 例（83.3%，40/48）存在双侧供血动脉。所有患者的 Cognard 分级均为 3-4 级（高分级）。48 例患者中，43 例（89.6%，43/48）引流至上矢状窦（SSS）。此外，36 例（75%，36/48）患者接受了经动脉栓塞治疗（TAE）。其中，28 例（77.8%，28/36）通过 OA 的 AEA 进行治疗。另有 12 例（25%，12/48）患者接受了经静脉栓塞治疗（TVE），其中 11 例（91.7%，11/12）通过经 SSS 途径进行治疗。44 例（91.7%，44/48）患者完全闭塞瘘口，4 例（8.3%，4/48）患者术后出现并发症。所有 48 例患者均有明确的随访结果描述，其中 45 例（93.8%，45/48）患者预后良好。因此，对于 ACF DAVF，血管内治疗（EVT）可以完全闭塞瘘口，纠正静脉分流，是治疗 ACF DAVF 的有效方法。尽管可能会发生多种并发症，但在大多数情况下，该方法可获得良好的治疗效果。
