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Diploic arteriovenous fistulas—classification and endovascular management

  • Clinical Article - Vascular
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Abstract

Background

The authors report on two cases of diploic arteriovenous fistulas (AVFs) in the left parieto-occipital region of a 20-year-old female and the right parietal region of a 68-year-old male. The clinical presentation, angiographic appearance, and endovascular management of these rare lesions are discussed.

Methods

Retrospective data from two patients with diplopic AVFs are examined with a review of all published cases of diploic arteriovenous fistulas.

Results

Where previously reported diploic AVFs showed venous drainage to be intracranial or combined, two case studies examined by the authors found exclusively extracranial drainage in the AVFs. In both case studies the lesions were primarily fed by the middle meningeal artery and treated via a transarterial endovascular approach using n-BCA glue.

Conclusions

After reviewing all reported cases of AVF in the literature and combining our two new observations, we concluded that diploic AVFs can have three types of venous outflow: draining toward dural sinuses only, toward extracranial veins only, and combining the dural and extracranial pathways.

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Conflicts of Interest

All authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Department of Neurology, Anesthesiology & Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA

    Lucia Rivera-Lara

  2. Radiology (Division of Interventional Neuroradiology), The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA

    Philippe Gailloud

  3. Department of Neurosurgery, Anesthesiology & Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA

    Paul Nyquist

Authors
  1. Lucia Rivera-Lara
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  2. Philippe Gailloud
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  3. Paul Nyquist
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Correspondence to Lucia Rivera-Lara.

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Rivera-Lara, L., Gailloud, P. & Nyquist, P. Diploic arteriovenous fistulas—classification and endovascular management. Acta Neurochir 157, 1485–1488 (2015). https://doi.org/10.1007/s00701-015-2505-6

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  • DOI: https://doi.org/10.1007/s00701-015-2505-6

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