Hiramatsu Masafumi, Haruma Jun, Sugiu Kenji, Tanaka Shota
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
No Shinkei Geka. 2024 May;52(3):596-604. doi: 10.11477/mf.1436204953.
The superior petrosal sinus and petrosal vein are important drainage routes for the posterior cranial fossa, with some variations and collateral vessels. An anterolateral-type tentorial dural arteriovenous fistula, which occurs around the petrosal vein, often develops aggressive symptoms due to venous reflux to the brainstem and cerebellum. Neuroendovascular treatment of this fistula is usually challenging because transarterial embolization has a high risk and indications for transvenous embolization are limited. In the cavernous sinus and transverse sinus/sigmoid sinus dural arteriovenous fistulas, venous reflux to the petrosal vein is dangerous, and a treatment strategy with the occlusion of the petrosal vein is indispensable. Furthermore, attention should be paid to venous approaches through the superior petrosal sinus.
岩上窦和岩静脉是后颅窝的重要引流途径,存在一些变异和侧支血管。发生在岩静脉周围的前外侧型小脑幕硬脑膜动静脉瘘,常因静脉反流至脑干和小脑而出现侵袭性症状。这种瘘的神经血管内治疗通常具有挑战性,因为经动脉栓塞风险高,经静脉栓塞的适应证有限。在海绵窦和横窦/乙状窦硬脑膜动静脉瘘中,静脉反流至岩静脉是危险的,闭塞岩静脉的治疗策略必不可少。此外,应注意通过岩上窦的静脉入路。