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Kiyoshi Matsumoto - One of the best experts on this subject based on the ideXlab platform.
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Variations of the superficial middle cerebral vein: classification using three-dimensional CT angiography
2015Co-Authors: Yasuhiro Suzuki, Kiyoshi MatsumotoAbstract:BACKGROUND AND PURPOSE: Classification of variations of the superficial middle cere-bral vein (SMCV) remains ambiguous. We propose a new classification system based on em-bryologic development for preoperative examination. METHODS: Three-dimensional CT angiography was used to evaluate 500 SMCVs (in 250 patients). The outflow vessels from the SMCV were classified into seven types on the basis of embryologic development. The 3D CT angiograms in axial stereoscopic and oblique views and multiple intensity projection images were evaluated by the same neurosurgeon on two occa-sions. Inconsistent interpretations were regarded as equivocal. RESULTS: Three-dimensional CT angiography clearly depicted the SMCV running along the lesser wing or the middle cranial fossa. However, the outflow vessel could not be confirmed as the Sphenoparietal, cavernous, or emissary type in 39 (8%) of the sides. SMCVs running in the middle cranial fossa to join the transverse Sinus or superior petrosal Sinus were accurately identified. SMCVs were present in 456 sides: 62 % entered the Sphenoparietal Sinus or the cavernous Sinus and 12 % joined the emissary vein. Nine vessels were the superior petrosal type, 10 the basal type, 12 the squamosal type, and 44 the undeveloped type
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Venous infarction resulting from sacrifice of a bridging vein during clipping of a cerebral aneurysm: preoperative evaluation using three-dimensional computed tomography angiography--case report.
Neurologia medico-chirurgica, 2003Co-Authors: Yasuhiro Suzuki, Takahiro Endo, Hisato Ikeda, Yukio Ikeda, Kiyoshi MatsumotoAbstract:A 67-year-old woman presented with a ruptured aneurysm of the left internal carotid artery bifurcation. Three-dimensional computed tomography angiography (3D-CTA) demonstrated the first segment of the basal vein of Rosenthal passing in front of the internal carotid artery and the anastomosis with the cavernous Sinus, the partially hypoplastic second segment, and the superficial sylvian vein entering the lateral side of the Sphenoparietal Sinus. Dissection of the sylvian fissure toward the distal direction enabled transfer of the superficial sylvian vein to the temporal side, but the bridging vein had to be sacrificed to secure adequate operating space. Postoperative CT demonstrated hemorrhagic infarction at the left caudate head and surrounding region. Postoperative venous infarction is not an uncommon complication of various approaches. 3D-CTA can provide important information about the venous anatomy indispensable for avoiding postoperative venous infarction.
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Variations of the basal vein: identification using three-dimensional CT angiography.
AJNR. American journal of neuroradiology, 2001Co-Authors: Yasuhiro Suzuki, Hisato Ikeda, Motohiko Shimadu, Yoshiho Ikeda, Kiyoshi MatsumotoAbstract:BACKGROUND AND PURPOSE: The basal vein of Rosenthal (BVR) presents with many variations because of its origin in the secondary longitudinal anastomoses between embryonic veins. The variations were evaluated by 3D CT angiography imaging. METHODS: Three-dimensional CT angiograms in the axial stereoscopic view and other directions constructed by the voxel transmission method and maximum intensity projection (MIP) images were obtained in 500 sides of 250 patients. RESULTS: The BVR flowed into the great vein of Galen in 87.8%, but the anastomoses between the first and second segments were not confirmed in 36.9% of this type. The first segments with hypoplastic or aplastic anastomoses flowed into the cavernous Sinus or the Sphenoparietal Sinus. Therefore, typical BVRs with these anastomoses accounted only for 55.4% of all sides. More than one fourth of the typical type also entered the anterior veins such as the cavernous Sinus. Drainage was to the lateral mesencephalic vein in 5.6%, peduncular vein in 1.6%, and lateral or medial tentorial Sinus in 5.0%. CONCLUSION: Variations of the BVR can be classified on the basis of the five drainage pathways formed during the early embryonic stage. Three-dimensional CT angiography can show the stereoscopic anatomy and the main drainage routes, but not hypoplastic veins, which are only visible on MIP images.
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variations of the superficial middle cerebral vein classification using three dimensional ct angiography
American Journal of Neuroradiology, 2000Co-Authors: Yasuhiro Suzuki, Kiyoshi MatsumotoAbstract:BACKGROUND AND PURPOSE: Classification of variations of the superficial middle cerebral vein (SMCV) remains ambiguous. We propose a new classification system based on embryologic development for preoperative examination. METHODS : Three-dimensional CT angiography was used to evaluate 500 SMCVs (in 250 patients). The outflow vessels from the SMCV were classified into seven types on the basis of embryologic development. The 3D CT angiograms in axial stereoscopic and oblique views and multiple intensity projection images were evaluated by the same neurosurgeon on two occasions. Inconsistent interpretations were regarded as equivocal. RESULTS : Three-dimensional CT angiography clearly depicted the SMCV running along the lesser wing or the middle cranial fossa. However, the outflow vessel could not be confirmed as the Sphenoparietal, cavernous, or emissary type in 39 (8%) of the sides. SMCVs running in the middle cranial fossa to join the transverse Sinus or superior petrosal Sinus were accurately identified. SMCVs were present in 456 sides: 62% entered the Sphenoparietal Sinus or the cavernous Sinus and 12% joined the emissary vein. Nine vessels were the superior petrosal type, 10 the basal type, 12 the squamosal type, and 44 the undeveloped type. CONCLUSION : Three-dimensional CT angiography can depict the vessels and their anatomic relationship to the bone structure, allowing identification of the SMCV variant in individual patients. Preoperative planning for skull base surgery requires such information to reduce the invasiveness of the procedure. With the use of our classification system, 3D CT angiography can provide exact and practical information concerning the SMCV.
Yasuhiro Suzuki - One of the best experts on this subject based on the ideXlab platform.
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Variations of the superficial middle cerebral vein: classification using three-dimensional CT angiography
2015Co-Authors: Yasuhiro Suzuki, Kiyoshi MatsumotoAbstract:BACKGROUND AND PURPOSE: Classification of variations of the superficial middle cere-bral vein (SMCV) remains ambiguous. We propose a new classification system based on em-bryologic development for preoperative examination. METHODS: Three-dimensional CT angiography was used to evaluate 500 SMCVs (in 250 patients). The outflow vessels from the SMCV were classified into seven types on the basis of embryologic development. The 3D CT angiograms in axial stereoscopic and oblique views and multiple intensity projection images were evaluated by the same neurosurgeon on two occa-sions. Inconsistent interpretations were regarded as equivocal. RESULTS: Three-dimensional CT angiography clearly depicted the SMCV running along the lesser wing or the middle cranial fossa. However, the outflow vessel could not be confirmed as the Sphenoparietal, cavernous, or emissary type in 39 (8%) of the sides. SMCVs running in the middle cranial fossa to join the transverse Sinus or superior petrosal Sinus were accurately identified. SMCVs were present in 456 sides: 62 % entered the Sphenoparietal Sinus or the cavernous Sinus and 12 % joined the emissary vein. Nine vessels were the superior petrosal type, 10 the basal type, 12 the squamosal type, and 44 the undeveloped type
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Preoperative evaluation of the venous system for potential interference in the clipping of cerebral aneurysm
Surgical neurology, 2004Co-Authors: Yasuhiro Suzuki, Hisato Ikeda, Yukio Ikeda, Masateru Nakajima, Takumi AbeAbstract:Abstract Background Variations of the venous system affecting the surgical treatment of cerebral aneurysm were evaluated using three-dimensional computed tomography angiography (3D-CTA) to evaluate the essential aspects of preoperative diagnosis. Methods This study included 50 patients who underwent clipping of cerebral aneurysm through the pterional and trans-sylvan approaches. The 3D-CTA and operative findings were compared to assess the characteristics of cases in which the veins restrict brain retraction, hinder operative manipulations or require sacrifice because of the position in the operative field. Results Superficial sylvian veins that restricted brain retraction were identified in 8 cases. The veins entered the cavernous Sinus in a relatively high position just below either the sphenoid ridge (superior lateral type) or the anterior clinoid process (superior medial type), and the veins entering at a more medial position were closer to the spatula and tended to be compressed or directly excluded (superior medial type). The inferior medial type did not tend to become tense and so did not restrict brain retraction. The inferior lateral type hardly affected the operative manipulation. The first segment of the basal vein of Rosenthal, the uncal vein entering the cavernous Sinus, or the Sphenoparietal Sinus were located in the operative field in six cases, and affected the manipulation of dissecting arteries, and exposure and clipping of the aneurysm. Conclusions 3D-CTA provides essential information for operative planning to protect the venous system during the pterional and trans-sylvian approaches.
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Venous infarction resulting from sacrifice of a bridging vein during clipping of a cerebral aneurysm: preoperative evaluation using three-dimensional computed tomography angiography--case report.
Neurologia medico-chirurgica, 2003Co-Authors: Yasuhiro Suzuki, Takahiro Endo, Hisato Ikeda, Yukio Ikeda, Kiyoshi MatsumotoAbstract:A 67-year-old woman presented with a ruptured aneurysm of the left internal carotid artery bifurcation. Three-dimensional computed tomography angiography (3D-CTA) demonstrated the first segment of the basal vein of Rosenthal passing in front of the internal carotid artery and the anastomosis with the cavernous Sinus, the partially hypoplastic second segment, and the superficial sylvian vein entering the lateral side of the Sphenoparietal Sinus. Dissection of the sylvian fissure toward the distal direction enabled transfer of the superficial sylvian vein to the temporal side, but the bridging vein had to be sacrificed to secure adequate operating space. Postoperative CT demonstrated hemorrhagic infarction at the left caudate head and surrounding region. Postoperative venous infarction is not an uncommon complication of various approaches. 3D-CTA can provide important information about the venous anatomy indispensable for avoiding postoperative venous infarction.
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Variations of the basal vein: identification using three-dimensional CT angiography.
AJNR. American journal of neuroradiology, 2001Co-Authors: Yasuhiro Suzuki, Hisato Ikeda, Motohiko Shimadu, Yoshiho Ikeda, Kiyoshi MatsumotoAbstract:BACKGROUND AND PURPOSE: The basal vein of Rosenthal (BVR) presents with many variations because of its origin in the secondary longitudinal anastomoses between embryonic veins. The variations were evaluated by 3D CT angiography imaging. METHODS: Three-dimensional CT angiograms in the axial stereoscopic view and other directions constructed by the voxel transmission method and maximum intensity projection (MIP) images were obtained in 500 sides of 250 patients. RESULTS: The BVR flowed into the great vein of Galen in 87.8%, but the anastomoses between the first and second segments were not confirmed in 36.9% of this type. The first segments with hypoplastic or aplastic anastomoses flowed into the cavernous Sinus or the Sphenoparietal Sinus. Therefore, typical BVRs with these anastomoses accounted only for 55.4% of all sides. More than one fourth of the typical type also entered the anterior veins such as the cavernous Sinus. Drainage was to the lateral mesencephalic vein in 5.6%, peduncular vein in 1.6%, and lateral or medial tentorial Sinus in 5.0%. CONCLUSION: Variations of the BVR can be classified on the basis of the five drainage pathways formed during the early embryonic stage. Three-dimensional CT angiography can show the stereoscopic anatomy and the main drainage routes, but not hypoplastic veins, which are only visible on MIP images.
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variations of the superficial middle cerebral vein classification using three dimensional ct angiography
American Journal of Neuroradiology, 2000Co-Authors: Yasuhiro Suzuki, Kiyoshi MatsumotoAbstract:BACKGROUND AND PURPOSE: Classification of variations of the superficial middle cerebral vein (SMCV) remains ambiguous. We propose a new classification system based on embryologic development for preoperative examination. METHODS : Three-dimensional CT angiography was used to evaluate 500 SMCVs (in 250 patients). The outflow vessels from the SMCV were classified into seven types on the basis of embryologic development. The 3D CT angiograms in axial stereoscopic and oblique views and multiple intensity projection images were evaluated by the same neurosurgeon on two occasions. Inconsistent interpretations were regarded as equivocal. RESULTS : Three-dimensional CT angiography clearly depicted the SMCV running along the lesser wing or the middle cranial fossa. However, the outflow vessel could not be confirmed as the Sphenoparietal, cavernous, or emissary type in 39 (8%) of the sides. SMCVs running in the middle cranial fossa to join the transverse Sinus or superior petrosal Sinus were accurately identified. SMCVs were present in 456 sides: 62% entered the Sphenoparietal Sinus or the cavernous Sinus and 12% joined the emissary vein. Nine vessels were the superior petrosal type, 10 the basal type, 12 the squamosal type, and 44 the undeveloped type. CONCLUSION : Three-dimensional CT angiography can depict the vessels and their anatomic relationship to the bone structure, allowing identification of the SMCV variant in individual patients. Preoperative planning for skull base surgery requires such information to reduce the invasiveness of the procedure. With the use of our classification system, 3D CT angiography can provide exact and practical information concerning the SMCV.
Cameron G Mcdougall - One of the best experts on this subject based on the ideXlab platform.
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aberrant venous drainage pattern in a medial sphenoid wing dural arteriovenous fistula a case report and review of the literature
World Neurosurgery, 2013Co-Authors: Joshua W Osbun, Robert F. Spetzler, Cameron G McdougallAbstract:Background Sphenoid wing region dural arteriovenous fistulas (DAVFs) are rare lesions that are typically fed by middle meningeal artery feeders and that drain via the Sphenoparietal Sinus or middle cerebral vein. We describe a unique case of a medial sphenoid wing fistula draining exclusively via the basal vein of Rosenthal. Methods A 55-year-old man presented with progressive right temporal homonymous hemianopsia. Cerebral angiography revealed a DAVF that rapidly filled into the deep venous system via the basal vein of Rosenthal with a large venous varix compressing the optic nerve. The sphenoid wing DAVF was not amenable to endovascular embolization due to direct ophthalmic artery feeders and was therefore treated with surgical obliteration. A right pterional craniotomy with orbitozygomatic osteotomy was performed. Results The fistula was clip ligated, and the venous varix was incised and drained. Intraoperative angiography demonstrated complete obliteration of the fistula. Conclusions Sphenoid wing DAVFs may drain via the deep venous system and have a complex arterial feeding network. Key features of the fistula, including deep venous drainage, presence of venous varices, and retrograde leptomeningeal venous drainage, make this an aggressive lesion with a high risk of rupture based on the available natural history data.
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surgical treatment of high risk intracranial dural arteriovenous fistulae clinical outcomes and avoidance of complications
Neurosurgery, 2007Co-Authors: Udaya K Kakarla, Cameron G Mcdougall, Vivek R Deshmukh, Joseph M Zabramski, Felipe C Albuquerque, Robert F. SpetzlerAbstract:OBJECTIVE: An increasing number of intracranial dural arteriovenous fistulae (DAVFs) are amenable to endovascular treatment. However, a subset of patients with high-risk lesions requires surgical intervention for complete obliteration. We reviewed our experience with the surgical management of high-risk intracranial DAVFs and offer recommendations to minimize complications based on fistula location and type. METHODS: Hospital records for 53 patients (16 women, 37 men) with high-risk intracranial DAVFs treated surgically between 1995 and 2004 were reviewed to determine their presenting symptoms, location, endovascular and surgical interventions, angiographic outcome, and treatment complications. Most patients (76%) presented with intracranial hemorrhage, progressive neurological deficits, or seizures. All patients had high-risk angiographic features such as cortical venous drainage or venous varix. Preoperative embolization was performed in 27 patients. Surgical approaches were tailored to the lesion location. Fistulae were located in the transverse-sigmoid junction (n = 18), tentorium (n = 17), ethmoid (n = 7), superior sagittal Sinus (n = 6), torcula (n = 4), and Sphenoparietal Sinus (n = 3). RESULTS: At the time of the last follow-up evaluation, 49 patients (92%) had good or excellent outcomes (Glasgow Outcome Scale score, 4 or 5) and three (6%) were deceased. Five patients had a residual fistula. One residual spontaneously thrombosed, one was treated with gamma knife radiosurgery, and two were successfully embolized. The overall morbidity and mortality rate was 13%. CONCLUSION: Despite fulminant presenting symptoms, high-risk intracranial DAVFs can be successfully managed with good outcomes. When anatomic features prevent endovascular access, or embolization fails to obliterate the lesion, urgent surgical treatment is indicated. Patients with residual filling of the DAVF should be considered for adjuvant therapy, including further embolization or radiosurgery.
Philippe Gailloud - One of the best experts on this subject based on the ideXlab platform.
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The Sphenoparietal Sinus.
Neurosurgery, 2008Co-Authors: Diego San Millán Ruíz, Jean H D Fasel, Philippe GailloudAbstract:OBJECTIVE There is minimal detailed information regarding the Sphenoparietal venous Sinus found in the extant medical literature. Furthermore, there is controversy in the literature regarding drainage of the Sylvian vein into this Sinus. The Sphenoparietal Sinus can potentially be encountered with cranial base approaches near the lesser wing of the sphenoid bone and may be found as one surgically traverses the superior orbital fissure. METHODS To further elucidate the anatomy of this structure, we injected this intracranial venous Sinus with blue latex in 15 adult cadavers (30 sides) via cannulation of the cavernous Sinus near the posterior part of the oculomotor trigone. Observations and measurements of this and nearby structures were then made. RESULTS A left and right Sphenoparietal Sinus were found in all specimens and had a mean diameter of 2.5 mm for left sides and 3 mm for right sides. No statistical difference was noted between sides or sexes (P > 0.05). This structure generally began at the lateral tip of the lesser wing of the sphenoid bone and ended in the cavernous Sinus near the passage of the ophthalmic nerve. In seven left sides and eight right sides, no discernible connection with the middle meningeal veins was noted. This Sinus was found to have a connection with the Sylvian vein in all but one side. One Sinus did not drain into the cavernous Sinus but rather into the veins of the foramen rotundum. Ten specimens were noted to have previously undocumented temporal veins from the anterior temporal tip that drained into the Sphenoparietal Sinus. CONCLUSION We think that these data will aid the clinician in the diagnosis of the pathology of this region and decrease morbidity that may follow manipulation of this venous Sinus.
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The Sphenoparietal Sinus of breschet: does it exist? An anatomic study.
AJNR. American journal of neuroradiology, 2004Co-Authors: Diego San Millán Ruíz, Jean H D Fasel, Daniel A. Rüfenacht, Philippe GailloudAbstract:BACKGROUND AND PURPOSE: The termination of the superficial middle cerebral vein is classically assimilated to the sphenoid portion of the Sphenoparietal Sinus. This notion has, however, been challenged in a sometimes confusing literature. The purpose of the present study was to evaluate the actual anatomic relationship existing between the Sphenoparietal Sinus and the superficial middle cerebral vein. METHODS: The cranial venous system of 15 nonfixed human specimens was evaluated by the corrosion cast technique (12 cases) and by classic anatomic dissection (three cases). Angiographic correlation was provided by use of the digital subtraction technique. RESULTS: The parietal portion of the Sphenoparietal Sinus was found to correspond to the parietal portion of the anterior branch of the middle meningeal veins. The sphenoid portion of the Sphenoparietal Sinus was found to be an independent venous Sinus coursing under the lesser sphenoid wing, the Sinus of the lesser sphenoid wing, which was connected medially to the cavernous Sinus and laterally to the anterior middle meningeal veins. The superficial middle cerebral vein drained into a paracavernous Sinus, a laterocavernous Sinus, or a cavernous Sinus but was never connected to the Sphenoparietal Sinus. All these venous structures were demonstrated angiographically. CONCLUSION: The Sphenoparietal Sinus corresponds to the artificial combination of two venous structures, the parietal portion of the anterior branch of the middle meningeal veins and a dural channel located under the lesser sphenoid wing, the Sinus of the lesser sphenoid wing. The classic notion that the superficial middle cerebral vein drains into or is partially equivalent to the Sphenoparietal Sinus is erroneous. Our study showed these structures to be independent of each other; we found no instance in which the superficial middle cerebral vein was connected to the anterior branch of the middle meningeal veins or the Sinus of the lesser sphenoid wing. The clinical implications of these anatomic findings are discussed in relation to dural arteriovenous fistulas in the region of the lesser sphenoid wing.
Robert F. Spetzler - One of the best experts on this subject based on the ideXlab platform.
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aberrant venous drainage pattern in a medial sphenoid wing dural arteriovenous fistula a case report and review of the literature
World Neurosurgery, 2013Co-Authors: Joshua W Osbun, Robert F. Spetzler, Cameron G McdougallAbstract:Background Sphenoid wing region dural arteriovenous fistulas (DAVFs) are rare lesions that are typically fed by middle meningeal artery feeders and that drain via the Sphenoparietal Sinus or middle cerebral vein. We describe a unique case of a medial sphenoid wing fistula draining exclusively via the basal vein of Rosenthal. Methods A 55-year-old man presented with progressive right temporal homonymous hemianopsia. Cerebral angiography revealed a DAVF that rapidly filled into the deep venous system via the basal vein of Rosenthal with a large venous varix compressing the optic nerve. The sphenoid wing DAVF was not amenable to endovascular embolization due to direct ophthalmic artery feeders and was therefore treated with surgical obliteration. A right pterional craniotomy with orbitozygomatic osteotomy was performed. Results The fistula was clip ligated, and the venous varix was incised and drained. Intraoperative angiography demonstrated complete obliteration of the fistula. Conclusions Sphenoid wing DAVFs may drain via the deep venous system and have a complex arterial feeding network. Key features of the fistula, including deep venous drainage, presence of venous varices, and retrograde leptomeningeal venous drainage, make this an aggressive lesion with a high risk of rupture based on the available natural history data.
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surgical treatment of high risk intracranial dural arteriovenous fistulae clinical outcomes and avoidance of complications
Neurosurgery, 2007Co-Authors: Udaya K Kakarla, Cameron G Mcdougall, Vivek R Deshmukh, Joseph M Zabramski, Felipe C Albuquerque, Robert F. SpetzlerAbstract:OBJECTIVE: An increasing number of intracranial dural arteriovenous fistulae (DAVFs) are amenable to endovascular treatment. However, a subset of patients with high-risk lesions requires surgical intervention for complete obliteration. We reviewed our experience with the surgical management of high-risk intracranial DAVFs and offer recommendations to minimize complications based on fistula location and type. METHODS: Hospital records for 53 patients (16 women, 37 men) with high-risk intracranial DAVFs treated surgically between 1995 and 2004 were reviewed to determine their presenting symptoms, location, endovascular and surgical interventions, angiographic outcome, and treatment complications. Most patients (76%) presented with intracranial hemorrhage, progressive neurological deficits, or seizures. All patients had high-risk angiographic features such as cortical venous drainage or venous varix. Preoperative embolization was performed in 27 patients. Surgical approaches were tailored to the lesion location. Fistulae were located in the transverse-sigmoid junction (n = 18), tentorium (n = 17), ethmoid (n = 7), superior sagittal Sinus (n = 6), torcula (n = 4), and Sphenoparietal Sinus (n = 3). RESULTS: At the time of the last follow-up evaluation, 49 patients (92%) had good or excellent outcomes (Glasgow Outcome Scale score, 4 or 5) and three (6%) were deceased. Five patients had a residual fistula. One residual spontaneously thrombosed, one was treated with gamma knife radiosurgery, and two were successfully embolized. The overall morbidity and mortality rate was 13%. CONCLUSION: Despite fulminant presenting symptoms, high-risk intracranial DAVFs can be successfully managed with good outcomes. When anatomic features prevent endovascular access, or embolization fails to obliterate the lesion, urgent surgical treatment is indicated. Patients with residual filling of the DAVF should be considered for adjuvant therapy, including further embolization or radiosurgery.
