Artikel
Neurosurgical options for treatment of cavernous sinus dural AVF
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Autoren
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M. Ezura
- Department of Neuroendovascular Therapy, Tohoku University
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A. Takahashi
- Department of Neuroendovascular Therapy, Tohoku University
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Y. Matsumoto
- Department of Neuroendovascular Therapy, Kohnan Hospital
| Veröffentlicht: | 8. Mai 2006 |
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Gliederung
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Objective: Although standard treatment of cavernous sinus dural arteriovenous fistula (AVF) is transvenous coil embolization, neurosurgical approach is occasionally indispensable in certain situation. We review our treatment of cavernous sinus dural AVF and study the role of neurosurgical options for the treatment of cavernous sinus dural AVF.
Methods: We treated 131 cases of cavernous sinus dural AVF in the last 12 years. Transfemoral inferior petrosal sinus (IPS) approach was initially tried in all the cases. The IPS approach was successful in 98 cases. A transfemoral facial vein approach was performed in 3 cases. A neurosurgical approach was performed in the remaining 30 cases. These are the object of this study.
Results: Transfemoral inferior petrosal sinus (IPS) approach was used first in all the cases. The neurosurgical approach followed if the IPS approach failed. A direct superior orbital vein approach was performed in 27 cases, and adirect Sylvian vein approach was used in 3 cases. A direct Sylvian approach was performed using a small craniotomy under general anesthesia. The cavernous sinus dural AVF was cured in all 30 cases. Complications were observed in 2 cases. One was an oculomotor palsy due to over-packing and one was posterior cerebral artery occlusion due to a diagnostic angiogram.
Conclusions: A neurosurgical approach is occasionally indispensable and very useful for the treatment of cavernous sinus dural AVF if the IPS approach is impossible.
