Baker Amanda, Hemphill Kafi, Smith Eric R, Cooke Daniel L, Hetts Steven W, Amans Matthew R, Higashida Randall T, Narsinh Kazim H
Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
Department of Neurology, University of California, San Francisco, CA, USA.
Interv Neuroradiol. 2023 Aug 8:15910199231188257. doi: 10.1177/15910199231188257.
Dural arteriovenous fistulas with drainage into the spinal veins, classified as Cognard type 5, can be challenging to diagnose and treat. Brainstem and cervical spinal cord signal abnormalities on magnetic resonance imaging result from venous congestion, and can mimic tumor, infection, or inflammation. Transarterial and transvenous embolization techniques can be used to treat dural arteriovenous fistulas endovascularly. Efficacious transvenous treatment relies on the ability to safely catheterize the draining vein at the dural arteriovenous fistula site. Transvenous access options may seem limited in the setting of occluded venous sinuses. This case highlights the technical aspects of the transvenous approach to embolization of a transverse-sigmoid sinus dural arteriovenous fistula within an isolated sinus, demonstrating traversal of the occluded venous sinus from a contralateral approach.[Media: see text].
引流至脊髓静脉的硬脑膜动静脉瘘，分类为Cognard 5型，诊断和治疗可能具有挑战性。磁共振成像上脑干和颈脊髓信号异常是由静脉充血引起的，可类似于肿瘤、感染或炎症。经动脉和经静脉栓塞技术可用于血管内治疗硬脑膜动静脉瘘。有效的经静脉治疗依赖于在硬脑膜动静脉瘘部位安全地将导管插入引流静脉的能力。在静脉窦闭塞的情况下，经静脉入路选择可能看似有限。本病例强调了经静脉途径栓塞孤立窦内横窦-乙状窦硬脑膜动静脉瘘的技术要点，展示了从对侧途径穿过闭塞静脉窦的过程。[媒体：见正文]
