Cognard C, Gobin Y P, Pierot L, Bailly A L, Houdart E, Casasco A, Chiras J, Merland J J
Service de Neuroradiologie, Hôpital Lariboisiere, Paris, France.
Radiology. 1995 Mar;194(3):671-80. doi: 10.1148/radiology.194.3.7862961.
To review the symptoms and progression of dural arteriovenous fistulas (AVFs) and correlate the findings with various angiographic patterns.
Patterns of venous drainage allowed classification of dural AVFs into five types: type I, located in the main sinus, with antegrade flow; type II, in the main sinus, with reflux into the sinus (IIa), cortical veins (IIb), or both (IIa + b); type III, with direct cortical venous drainage without venous ectasia; type IV, with direct cortical venous drainage with venous ectasia; and type V, with spinal venous drainage.
Type I dural AVFs had a benign course. In type II, reflux into the sinus induced intracranial hypertension in 20% of cases, and reflux into cortical veins induced hemorrhage in 10%. Hemorrhage was present in 40% of cases of type III dural AVFs and 65% of type IV. Type V produced progressive myelopathy in 50% of cases.
This classification provides useful data for determination of the risk with each dural AVF and enables decision-making about the appropriate therapy.
回顾硬脑膜动静脉瘘（AVF）的症状和进展情况，并将这些发现与各种血管造影模式相关联。
根据静脉引流模式，硬脑膜AVF可分为五种类型：I型，位于主要静脉窦，血流呈顺行性；II型，位于主要静脉窦，血液反流至静脉窦（IIa）、皮质静脉（IIb）或两者（IIa + b）；III型，直接引流至皮质静脉，无静脉扩张；IV型，直接引流至皮质静脉，伴有静脉扩张；V型，伴有脊髓静脉引流。
I型硬脑膜AVF病程良性。II型中，血液反流至静脉窦导致20%的病例出现颅内高压，反流至皮质静脉导致10%的病例出血。III型硬脑膜AVF病例中有40%出现出血，IV型为65%。V型在50%的病例中导致进行性脊髓病。
该分类为确定每种硬脑膜AVF的风险提供了有用的数据，并有助于做出适当治疗的决策。
