European Radiology

, Volume 2, Issue 5, pp 452–458 | Cite as

Embolization of dural arteriovenous fistulas draining into the transverse or sigmoid sinus

  • B. Berthelsen
Original Articles Neuroradiology


The results of embolisation of dural arteriovenous fistulas draining into the transverse or sigmoid sinus were evaluated in 20 patients. Tinnitus was the main symptom in all patients although one also suffered from vertigo and sudden deafness. Nine patients were treated with PVA (polyvinylalcohol) alone and 11 with combined PVA and bucrylate (isobutyl-2-cyanoacrylate) in 1–9 procedures. Recurrence of symptoms, requiring repeated procedures was common but at subsequent clinical follow up 10 patients had no tinnitus, 5 were improved and only 5 experienced no change. Complications occured in six patients: four had transient neurological symptoms and one of these also developed a necrotic wound which later healed. One patient suffered from a cranial nerve palsy and one had an intracranial haemorrhage after a transvenous embolisation. This last patient recovered completely. The best clinical results were achieved in small fistulas and fistulas treated with combined bucrylate and PVA.

Key words

Arteriovenous malformations, cerebral Fistulas, dural Sinuses, dural Embolisation, therapeutic 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aminoff MJ (1973) Vascular anomalies in the intracranial dura mater. Brain 96: 601–612Google Scholar
  2. 2.
    Djindjian R, Merland JJ (1978) Meningeal arteriovenous fistulae. In: Djindjian R and Merland JJ eds. Superselective arteriography of the external carotid artery. Springer, Berlin Heidelberg New York, pp 405–412Google Scholar
  3. 3.
    Lasjaunias P, Chiu M, Ter Brugge K, Tolia A, Hurth M, Bernstein M (1986) Neurological manifestations of intracranial dural arteriovenous malformations. J Neurosurg 64: 724–730Google Scholar
  4. 4.
    Obrador S, Soto M, Silvela J (1975) Clinical syndromes of arteriovenous malformations of the transverse-sigmoid sinus. J Neurol Neurosurg Psychiatry 38: 436–451Google Scholar
  5. 5.
    Chaudhary MY, Sachdev VP, Cho SH, Wetzner I Jr, Puljic S, Huang YP (1982) Dural arteriovenous malformation of the major venous sinuses: an aquired lesion. AJNR 3: 13–19Google Scholar
  6. 6.
    Houser OW, Campbell JK, Campbell RJ, Sundt TM (1979) Arteriovenous malformations affecting the transverse dural sinus —an aquired lesion. Mayo Clin Proc 54: 651–661Google Scholar
  7. 7.
    Kühner A, Krastel A, Stoll W (1976) Arterivenous malformations of the transverse dural sinus. J Neurosurg 45: 12–19Google Scholar
  8. 8.
    Sundt TM, Piepgras DG (1983) The surgical approach to arteriovenous malformations of the lateral and sigmoid dural sinuses. J Neurosurg 59: 32–39Google Scholar
  9. 9.
    Halbach VV, Higashida RT, Hieshima GB, Goto K, Norman D, Newton TH (1987) Dural fistulas involving the transverse and sigmoid sinuses: results of treatment in 28 patients. Radiology 163: 443–447Google Scholar
  10. 10.
    Djindjian R, Cophignon J, Theron J, Merland JJ, Houdart R (1973) Embolization by superselective arteriography from the femoral route in neuroradiology. Review of 60 cases. 1. Technique, indications, complications. Neuroradiology 6: 20–26Google Scholar
  11. 11.
    Fermand M, Reizine D, Melki JP, Riche MC, Merland JJ (1987) Long term follow up of 43 pure dural arteriovenous fistulas of the lateral sinus. Neuroradiology 29: 348–353Google Scholar
  12. 12.
    Picard L, Bracard S, Mallet J, Per A, Giacoppe HL, Roland J (1987) Spontaneous dural arteriovenous fistulas. Semin Intervent Radiol 4: 219–240Google Scholar
  13. 13.
    Lasjaunias P, Halimi P Lopez-Ibor L, Sichez JP, Hurth M, De Tribolet N (1983) Traitement endovasculaire des malformations vasculaires durales (MVD) pures “spontanées”. Revue de 23 cas explorés et traités entre mai 1980 et octobre 1983. Neurochirurgie 30: 207–223Google Scholar
  14. 14.
    Russel EJ (1986) Functional angiography of the head and neck. AJNR 7: 927–936Google Scholar
  15. 15.
    Herrera M, Rysavy J, Kotula F, Rusnak B, Castaneda-Zuniga WR, Amplatz K (1982) Ivalon shavings: technical considerations of a new embolic agent. Radiology 144: 638–640Google Scholar
  16. 16.
    Cromwell LD, Kerber CW (1079) Modification of cyanoacrylate for therapeutic embolization: pereliminary experience. AJNR 132: 799–801Google Scholar
  17. 17.
    Barnwell SL, Halbach VV, Higashida RT, Hieshima G, Wilson C (1989) Complex dural arteriovenous fistulas. Results of combined endovascular and neurosurgical treatment in 16 patients. J Neurosurg 71: 352–358Google Scholar
  18. 18.
    Halbach VV, Higashida RT, Hieshima GB, Mehringer CM Hardin CW (1989) Transvenous embolization of dural fistulas involving the transverse and sigmoid sinuses. AJNR 10: 385–392Google Scholar
  19. 19.
    Berenstein A, Lasjaunias P, Quisling RG, Strother C, Choi IS (1986) Vascular recanalization of non-biogradable embolic agents (abstract). Acta Radiol [Suppl] 369: 772Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • B. Berthelsen
    • 1
  1. 1.Department of RadiologySahlgrenska SjukhusetGöteborgSweden

Personalised recommendations