Arnautović K I, Al-Mefty O, Angtuaco E, Phares L J
Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock 72205-7199, USA.
Neurosurgery. 1998 Feb;42(2):383-8. doi: 10.1097/00006123-199802000-00112.
Debate continues regarding the pathogenesis of dural arteriovenous malformations (dAVMs). The prevailing theory is that dAVMs are acquired lesions that occur after thrombosis of the dural venous sinus.
We report unique cases of two patients having different tumors (one meningioma and one glomus jugulare paraganglioma) that occluded the ipsilateral transverse and sigmoid sinuses, respectively, and were associated with dAVMs. In each patient, the occluded venous sinus was the dominant sinus.
Our experience with these patients supports the hypothesis that dAVMs are acquired and induced lesions that may occur after sinus occlusion. We suggest that the occlusion of the dominant transverse/ sigmoid sinus is a major contributing factor to the development of dAVMs because of the inability of the contralateral (nondominant) sinus to handle the venous flow from the obstructed (dominant) side.
关于硬脑膜动静脉畸形（dAVM）的发病机制仍存在争议。目前流行的理论是，dAVM是硬脑膜静脉窦血栓形成后出现的后天性病变。
我们报告了两例独特的病例，两名患者分别患有不同的肿瘤（一例脑膜瘤和一例颈静脉球副神经节瘤），它们分别阻塞了同侧的横窦和乙状窦，并与dAVM相关。在每例患者中，阻塞的静脉窦均为主窦。
我们对这些患者的经验支持了dAVM是后天性和诱发性病变且可能在窦阻塞后发生的假说。我们认为，由于对侧（非主）窦无法处理来自阻塞（主）侧的静脉血流，主横窦/乙状窦的阻塞是dAVM发生的主要促成因素。
