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Pediatr Radiol 2020 Jul 8. Epub 2020 Jul 8.

Division of Neuroradiology, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.

This article is the second of a two-part series on intracranial calcification in childhood. In Part 1, the authors discussed the main differences between physiological and pathological intracranial calcification. They also outlined histological intracranial calcification characteristics and how these can be detected across different neuroimaging modalities. Read More

World Neurosurg 2020 Jun 10. Epub 2020 Jun 10.

Gamma-Knife Radiosurgery Unit. Hospital Ruber Internacional. Calle la Maso, 38-28034. Madrid.

Background: Klippel-Trenaunay-Weber syndrome (KTWS) is characterized by the presence of a combined vascular malformation of capillaries, veins, and lymphatic vessels, congenital venous abnormalities, and limb hypertrophy. Its association with neurovascular abnormalities is infrequent, and the presence of intracranial arteriovenous malformations (AVMs) is extremely rare.

Case Description: We report a case of a 48-year-old male diagnosed with KTWS who spontaneously presented with a cerebral hemorrhage. Read More

BMC Infect Dis 2020 May 24;20(1):370. Epub 2020 May 24.

Department of Neurology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong Province, China.

Background: Brain abscesses, a severe infectious disease of the CNS, are usually caused by a variety of different pathogens, which include Streptococcus intermedius (S. intermedius). Pulmonary arteriovenous fistulas (PAVFs), characterized by abnormal direct communication between pulmonary artery and vein, are a rare underlying cause of brain abscesses. Read More

Neurol Sci 2020 Apr 25. Epub 2020 Apr 25.

Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.

Cerebrovascular malformations are uncommon diverse group of dysmorphic vascular communications that may occur sporadically or as part of genetic syndromes. These include non-neoplastic lesions such as arteriovenous malformations (AVM), cavernous malformations (CM), developmental venous anomalies (DVA), and telangiectasias as well as others like arteriovenous fistulas (AVF), vein of Galen malformations (VOGM), and mixed or unclassified angiomas. These lesions often carry a high degree of morbidity and mortality often requiring surgical or endovascular interventions. Read More

J Neurosurg Spine 2020 Apr 24:1-11. Epub 2020 Apr 24.

8Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo.

Objective: Spinal arteriovenous shunts are rare vascular lesions and are classified into 4 types (types I-IV). Due to rapid advances in neuroimaging, spinal epidural AVFs (edAVFs), which are similar to type I spinal dural AVFs (dAVFs), have recently been increasingly reported. These 2 entities have several important differences that influence the treatment strategy selected. Read More

World Neurosurg 2020 Apr 21;139:238-241. Epub 2020 Apr 21.

Department of Neurosurgery, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia; Neurosurgery Department, Stanford University, Stanford, California, USA.

Background: Sinus pericranii (SP) is a rare vascular condition that results when abnormal communication between the intracranial and extracranial venous systems is present. Here we report a rare case of hydrocephalus revealed through a SP scalp mass with a review of literature.

Case Description: A 13-year-old girl presented with a history of bulging left eye, bilateral gradual deterioration of vision, nausea, and progressive headaches. Read More

World Neurosurg 2020 Jun 2;138:398-403. Epub 2020 Apr 2.

Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.

Background: Klippel-Trenaunay syndrome (KTS) is associated with a wide variety of vascular and neurologic abnormalities, including venolymphatic malformations. A recent report postulated that patients with KTS may also be predisposed to spontaneous intracranial hypotension. We reviewed brain magnetic resonance imaging from 67 patients with KTS and unexpectedly noted findings of cerebrospinal fluid (CSF) hypotension in 4 of them. Read More

Br J Radiol 2020 Jun 25;93(1110):20190830. Epub 2020 Mar 25.

University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.

Objectives: To compare the performance of arterial spin labelling (ASL) in evaluating arteriovenous malformations (AVMs) against the current gold standard of catheter angiography.

Methods: We systematically reviewed the published literature using EMBASE and Medline. We included studies that compared ASL to catheter angiography in the assessment of AVMs in three outcome domains: detection, angioarchitectural and haemodynamic features. Read More

Medicine (Baltimore) 2020 Jan;99(3):e18873

Department of Neurosurgery, Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, Zhejiang, China.

Rationale: Trigeminal neuralgia (TN) is frequently associated with compression at the root entry zone of the trigeminal nerve by an aberrant loop of an artery, tributaries of the petrosal vein, tumors, aneurysm, and vascular malformation. TN associated with a cerebellar pial arteriovenous fistula (PAVF) has not been described previously.

Patient Concerns: A 65-year-old man presented with right-sided TN. Read More

World Neurosurg 2020 Apr 16;136:157-160. Epub 2020 Jan 16.

Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Aoba-ku, Sendai, Miyagi, Japan.

Background: Spinal dural arteriovenous fistulas (DAVFs) are usually associated with neurologic dysfunction adjacent to the shunt point; however, the symptoms are uncommon far from the site of the fistula. To our knowledge, this is the first report of a patient with rapidly progressive isolated pseudobulbar palsy because of thoracic DAVF.

Case Description: We report a patient with thoracic DAVF presenting with remote symptoms of brainstem congestion. Read More

J Headache Pain 2020 Jan 16;21(1). Epub 2020 Jan 16.

Clinica Neurologica, Dipartimento di Neuroscienze, Policlinico Gemelli, Università Cattolica, Rome, Italy.

Background: Dural arteriovenous fistulas are intracranial vascular malformations, fed by dural arteries and draining venous sinuses or meningeal veins. Clinical course varies widely and ranges from benign with spontaneous remission to fatal, due to cerebral hemorrhage. In a 10-year single institution experience, clinical presentation of dural arteriovenous fistulas, and in particular headache and angiographic features, as well as long-term outcome were analyzed. Read More

Neuroradiology 2020 Apr 14;62(4):417-425. Epub 2020 Jan 14.

Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, UHN, University of Toronto, Toronto, Ontario, Canada.

Cerebrofacial venous metameric syndrome (CVMS) is a complex craniofacial vascular malformation disorder in which patients have a constellation of venous vascular malformations affecting soft tissues, bone, dura, and neural structures including the eye and brain. It is hypothesized that a somatic mutation responsible for the venous abnormalities occurred prior to migration of the neural crest cells, and because of this, facial, osseous, and cerebral involvement typically follows a segmental or "metameric" distribution. The most commonly recognized form of CVMS is Sturge-Weber syndrome. Read More

Radiographics 2020 Jan-Feb;40(1):122-140

From the Department of Diagnostic Radiology, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140.

With phase-contrast imaging, the MRI signal is used to visualize and quantify velocity. This imaging modality relies on phase data, which are intrinsic to all MRI signals. With use of bipolar gradients, degrees of phase shift are encoded and in turn correlated directly with the velocity of protons. Read More

Medicine (Baltimore) 2019 Dec;98(52):e18418

Department of Neurosurgery.

Rationale: Brain arteriovenous malformation (BAVM)-associated varix is always asymptomatic, and no special treatment is needed. However, there is no consensus regarding how to address a varix that has led to clinical manifestation.

Patient Concerns: An 11-year-old girl was admitted complaining of left hemiparesis for 4 days. Read More

No Shinkei Geka 2019 Dec;47(12):1247-1254

Department of Neurosurgery & Neuroendovascular Therapy, Osaka Medical College.

Objective: We report an unusual case of tentorial dural arteriovenous fistula(DAVF)with bithalamic lesions and bilateral intracranial hemorrhage.

Case Presentation: A 73-year-old man presented with lethargy and progressive cognitive decline. Imaging demonstrated bithalamic edematous lesions and bilateral basal ganglia hemorrhage in the right putamen and left internal capsule. Read More

World Neurosurg 2020 Mar 21;135:262-266. Epub 2019 Dec 21.

Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.

Background: Spontaneous cerebrospinal fluid (CSF) leaks can be an intractable cause of orthostatic headaches but have several treatable causes. CSF-venous fistulas are an increasingly recognized cause of rapid CSF leaks. Although CSF-venous fistulas have been previously reported in the literature, their imaging appearance, associated anomalies, and treatment are incompletely understood. Read More

J Pediatr 2020 Mar 20;218:85-91.e2. Epub 2019 Dec 20.

Department of Interventional Neuroradiology Neuro Brain vascular center, Paris-Saclay University Hospitals, Bicêtre medical center, Assistance publique-hôpitaux de Paris, France.

Objectives: To assess the management and outcomes of neonatal arteriovenous brain malformations (mostly vein of Galen malformations) complicated by cardiac failure in the era of prenatal diagnosis and endovascular treatment in a tertiary referral center.

Study Design: This observational study included 77 living newborn infants with arteriovenous brain malformations with cardiac failure, admitted to our referral center from 2001 to 2017. All infants underwent cardiovascular evaluation including echocardiogram and brain magnetic resonance imaging. Read More

AJR Am J Roentgenol 2020 02 11;214(2):428-436. Epub 2019 Dec 11.

Department of Radiology, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 10 5530, Albuquerque, NM 87131.

The purpose of this study was to investigate whether MRI-typical and MRI-atypical intraosseous vascular malformations are associated with familial cerebral cavernous malformation (FCCM). In a retrospective matched case-control study, two radiologists reviewed the spinal imaging, both CT and MRI, of 22 patients with FCCM seen between 2006 and 2017 and of age- and sex-matched control subjects for MRI-typical and MRI-atypical intraosseous vascular malformations. Quantitative analysis of lesions identified included vertebral level, size, and number of lesions. Read More

J Coll Physicians Surg Pak 2019 Dec;29(12):S74-S76

Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan.

This case series summarises the successful management of two cases with cerebral arterio-venous malformation (AVM). In first patient, it was located superficially in right frontal cortex, while the second one had this in left parieto-temporal region. Both were excised successfully using awake craniotomy. Read More

Medicine (Baltimore) 2019 Nov;98(48):e18184

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, PR China.

Rationale: Dual aneurysms arising from the internal cerotic artery (ICA) is a very rare occurrence. Clinoid segment aneurysms (CSAs) are often seen at the carotid dural rings while cavernous carotid aneurysms (CCAs) are often a direct communication between the ICA and the cavernous sinus (CS). We present a case of complex concomitant occurrence of a CSA and a CCA complicated with delay aneurysmal rupture (DAR) resulting in carotid cavernous fistula (CCF) after our initial treatment of the patient with pipeline embolization devices (PLEDs) PATIENT CONCERNS:: We present a 64-year old female who we admitted at our institution due to one-year history of double vision. Read More

Pan Afr Med J 2019 26;34:52. Epub 2019 Sep 26.

Service de Radiologie du Centre Hospitalier Jacques Boutard, Saint-Yrieix-la-Perche, France.

Galen aneurysmal malformation is a rare complex congenital vascular malformation of the brain, (less than 1% of intracranial arteriovenous malformations) characterized by pseudoaneurismal dilation of Galen's ampulla associated with one or several arteriovenous fistulas. In most cases, diagnosis is made in the neonatal or postnatal period, exceptionally in adulthood. We report the case of an 18-year male patient hospitalized for psychomotor retardation. Read More

Neurol Clin 2020 02 7;38(1):185-199. Epub 2019 Nov 7.

Neurology, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15222, USA.

Acute stroke is the clinical manifestation of disrupted blood flow or bleeding in the central nervous system. Imaging supports the clinical diagnosis and can aide in acute treatment decision making and guide information on prognosis. Features that are delineated include the parenchyma and the blood vessels. Read More

World Neurosurg 2020 Feb 20;134:427. Epub 2019 Nov 20.

Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California, USA; Department of Neurological Surgery, University of California, San Francisco, California, USA. Electronic address:

A 39-year-old man presented with a large left paramedian frontal lobe intracerebral hemorrhage. Computed tomography angiography and magnetic resonance imaging revealed a tangle of vessels arising from the anterior cerebral arteries (ACAs) and dilated draining veins entering the superior sagittal sinus. Angiography confirmed a Spetzler-Martin grade 3, supplemented 2 arteriovenous malformation (AVM) with predominant supply from branches of the left ACA with superficial and deep drainage (Video 1). Read More

J Comput Assist Tomogr 2019 Nov/Dec;43(6):943-947

From the Department of Neuroradiology, Radiology, and Neurosurgery, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama City, Fukushima, Japan.

Objective: Silent magnetic resonance angiography (MRA) was compared with time-of-flight (TOF)-MRA in imaging of arteriovenous malformations (AVMs) of the brain.

Methods: Thirty-five consecutive patients with AVMs of the brain were included. Quantitative analyses were performed by measuring both signal-to-noise ratio and contrast-to-noise ratio of the nidus. Read More

World Neurosurg 2020 Feb 11;134:377. Epub 2019 Nov 11.

Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Italy. Electronic address:

Tentorial dural arteriovenous fistulas are rare causes of intracranial hemorrhage and nervous tissue venous congestion. Due to their extensive arterial supply and difficult transvenous endovascular navigation, they are frequently managed microsurgically. Precise identification of the venous drainage, its retractorless exposition, and real-time verification of arteriovenous disconnection are the mainstays of surgery. Read More

J Neurosurg Spine 2019 Nov;32(2):305-310

2Radiology, Cedars-Sinai Medical Center, Los Angeles, California.

Spontaneous CSF-venous fistulas may be present in up to one-fourth of patients with spontaneous intracranial hypotension. This is a recently discovered type of CSF leak, and much remains unknown about these fistulas. Spinal CSF-venous fistulas are usually seen in coexistence with a spinal meningeal diverticulum, suggesting the presence of an underlying structural dural weakness at the proximal portion of the fistula. Read More

J Stroke Cerebrovasc Dis 2019 Dec 26;28(12):104461. Epub 2019 Oct 26.

Department of Neurosurgery, Japanese Red Cross Takayama Hospital, Takayama, Gifu, Japan.

While hemorrhage can occur because of developmental venous anomalies (DVAs), there is no established opinion concerning their association with pregnancy and childbirth. In the present report, we discuss the case of a now 39-year-old woman with DVA in whom pregnancy and childbirth were successful. When she was 28, she experienced disturbance of consciousness and paralysis on the left side of the body, and brain computed tomography revealed cerebral hemorrhage coupled with subarachnoid hemorrhage. Read More

BMJ Case Rep 2019 Oct 23;12(10). Epub 2019 Oct 23.

Department of Medicine, BUMED, Falls Church, Virginia, USA.

Pulmonary arteriovenous malformations (PAVMs) are a rare cause of pulmonary symptoms, including dyspnoea on exertion, hypoxemia and haemoptysis. PAVMs are an aetiology that is often overlooked by physicians when developing a differential diagnosis for pulmonary symptoms and unidentified lung masses. However, it is an important differential diagnosis to have as PAVMs can have serious sequelae including strokes, brain abscess and life-threatening bleeding. Read More

Yonsei Med J 2019 Nov;60(11):1112-1115

Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.

Direct puncture and embolization of the transverse sinus (TS) for treatment of dural arteriovenous fistula (DAVF) is typically performed with coils with or without glue. We report a case of DAVF at the left TS that was treated with Onyx embolization via direct puncture of the TS. A 75-year-old woman presented with tremor, festinating gait, and dysarthria. Read More

World Neurosurg 2020 Jan 18;133:e479-e486. Epub 2019 Sep 18.

Department of Neurosurgery, North-Shore Hospital, Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York, USA; Department of Radiology, North-Shore Hospital, Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York, USA.

Background: Cavernous carotid fistulas (CCF) are anatomically complex vascular lesions. Treatment via the venous approach has been previously described and is highly dependent on the patency of the drainage pathways. The use of a unilateral approach to contralateral or bilateral shunts is technically challenging and not commonly described. Read More

Pract Neurol 2019 Dec 18;19(6):518-520. Epub 2019 Sep 18.

Neurosciences Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

A 78-year-old woman presented with features of bilateral, asymmetric Parkinsonism for 1 year, with prominent difficulties with continence, swallowing and apathy. Brain imaging showed evidence of chronic venous sinus thrombosis with dilated serpiginous vessels over the brain surface in keeping with a dural arteriovenous fistula, together with high T2 signal on MRI in the basal ganglia. Having responded only modestly to levodopa, she received 6 months of anticoagulation followed by embolisation of the dural arteriovenous fistula, with good response. Read More

J Neuroimaging 2019 Nov 17;29(6):673-688. Epub 2019 Sep 17.

Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA.

Variations in the venous drainage of the central nervous system can have imaging and clinical findings that mimic pathology, presenting a challenge for neuroimagers and clinicians. Patients with these variants may undergo unnecessary testing, and patients with pathology may receive delayed diagnoses because of overlap with benign findings. Consequently, the accurate identification of venous variations on cross-sectional imaging and angiography and their potential causes are critical for differentiating benign imaging variants from potential pathologic processes requiring further evaluation. Read More

Surg Neurol Int 2019 28;10:128. Epub 2019 Jun 28.

Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Background: Cerebral arteriovenous malformations (AVMs) are vascular lesions with a network of dysplastic vessels between an arterial and a venous tree with no intervening capillary bed. They most commonly present with an acute hemorrhage, seizures, or persistent headaches.

Case Description: The authors report the case of a 62-year-old male who presented with diplopia for 5 days. Read More

World Neurosurg 2020 Jan 13;133:205-211. Epub 2019 Sep 13.

Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

Background: Diverse clinical manifestations have characterized reports of central nervous system involvement in Behcet disease. There is a limited number of published case reports of neuro-Behcet disease mimicking brain tumor.

Case Description: We present a rare case of neuro-Behcet disease exhibiting mixed systemic and neurological symptoms mimicking malignant lymphoma. Read More

World Neurosurg 2019 Dec 11;132:389. Epub 2019 Sep 11.

Department of Neurosurgery, Huashan Hospital, Shanghai Medical Collage, Fudan University, Shanghai, China. Electronic address:

Thalamic cavernous malformations (CM) are highly challenging surgically. In this illustrative video (Video 1), we present the case of a 36-year-old man with a CM at the left medial thalamus, which was successfully treated by a contralateral anterior interhemispheric transcallosal approach. Informed consent was obtained from the patient. Read More

Circ Res 2019 10 9;125(10):e43-e54. Epub 2019 Sep 9.

From the Department for Animal Physiology, Institute of Biochemistry and Biology, Potsdam University, Germany (C.J.R., C.O., S.D., M.L., D.F., A.P., S.A.-S.).

Rationale: Pathological biomechanical signaling induces vascular anomalies including cerebral cavernous malformations (CCM), which are caused by a clonal loss of CCM1/KRIT1 (Krev interaction trapped protein 1), CCM2/MGC4607, or CCM3/PDCD10. Why patients typically experience lesions only in lowly perfused venous capillaries of the cerebrovasculature is completely unknown.

Objective: In contrast, animal models with a complete loss of CCM proteins lack a functional heart and blood flow and exhibit vascular anomalies within major blood vessels as well. Read More

BMJ Case Rep 2019 Sep 4;12(9). Epub 2019 Sep 4.

Department of Radiology, UCLA Medical Center, Los Angeles, California, USA.

Embolisation of neonatal arteriovenous shunts poses several challenges: tortuous and fragile vessels, limited contrast volume and few specialised paediatric endovascular devices. In a 9-day-old patient with a choroidal type vein of Galen malformation we encountered an extremely tortuous posterior choroidal artery pedicle during endovascular treatment. After attempted selection using a traditional over-the-wire technique, we advanced a platinum coil through the micro-catheter. Read More

AJNR Am J Neuroradiol 2019 09;40(9):1484-1490

From the Department of Radiology (S.S., J.Y., X.L., Q.Z., H.Z., J.W.), Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China

Background And Purpose: Zero TE-MRA is less sensitive to field heterogeneity, complex flow, and acquisition noise. This study aimed to prospectively validate the feasibility of zero TE-MRA for cerebrovascular diseases assessment, compared with TOF-MRA.

Materials And Methods: Seventy patients suspected of having cerebrovascular disorders were recruited. Read More

J Neurol Surg A Cent Eur Neurosurg 2020 Jan 29;81(1):80-85. Epub 2019 Aug 29.

Klinik für Neuroradiologie, Otto-von-Guericke-Universität Magdeburg, Sachsen-Anhalt, Germany.

Objective:  Dural arteriovenous fistulas of the craniocervical junction are rare but the most dangerous of spinal fistulas. The concurrent brainstem edema has been attributed to increased pressure within the venous outflow of the brainstem and upper cord, but the differential diagnosis of brainstem edema is demanding. This report presents the details of clinical findings, magnetic resonance imaging (MRI) , surgical techniques, and follow-up of these fistulas. Read More

Medicine (Baltimore) 2019 Aug;98(33):e16440

Department of Mathematical Sciences, University of Cincinnati, Cincinnati, OH.

Rationale: Consumption of oral contraceptive pills (OCP) is a known risk factor for cerebral venous sinus thrombosis (CVST) among women. Development of dural arteriovenous fistula (dAVF) afterwards was very uncommon. We present a rare chronic complication of development of dAVF after CVST. Read More

Stroke 2019 09 14;50(9):2565-2567. Epub 2019 Aug 14.

From the Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO (B.P., G.J.Z.).

Background and Purpose- Several angiographic factors of dural arteriovenous fistulas (dAVFs) are associated with aggressive presentation and poor natural history. We examined the association of magnetic resonance imaging T2-weighted-Fluid-Attenuated Inversion Recovery (T2/FLAIR) hyperintensity with aggressive presentation. Methods- A cohort of dAVF patients from 2 centers was retrospectively examined. Read More

J Craniofac Surg 2019 Nov-Dec;30(8):2429-2431

Division of Plastic Surgery, Albany Medical Center, Albany, NY.

Scalp arteriovenous malformations (AVMs) are rare entities that may present as large, tortuous vascular lesions with resultant craniofacial deformity. Radiologic findings include feeding arteries and veins associated with dilated tortuous vessels. Intracranial extension is rare. Read More

World Neurosurg 2019 Nov 7;131:116-119. Epub 2019 Aug 7.

Department of Neurosurgery, Fukui Red Cross Hospital, Fukui, Japan.

Background: Occipital sinus (OS) dural arteriovenous fistula (DAVF) is extremely rare, and we are aware of no case accompanied by cerebral hemorrhage. We present a case of OS DAVF presenting with cerebellar hemorrhage, treated successfully by transvenous embolization.

Case Description: A 62-year-old female presented with headache and nausea of recent onset. Read More

World Neurosurg 2019 Nov 27;131:21-26. Epub 2019 Jul 27.

Department of Neurointervention, Henan Provincial People's Hospital, Zhengzhou, China. Electronic address:

Background: During endovascular treatment of complex intracranial dural arteriovenous fistulas (DAVFs) of the transverse sigmoid sinus, it can be difficult to preserve the patency of the dural sinus. We have described the details of the transvenous balloon-assisted technique using Copernic RC balloon as a treatment option for patients with complex DAVFs of the transverse sigmoid sinus.

Case Description: In these 2 cases, the Copernic RC balloon was navigated into the internal jugular vein and placed at the distal end of the DAVFs in the transverse sinus. Read More

World Neurosurg 2019 Nov 26;131:87-89. Epub 2019 Jul 26.

Department of Pathology, Federal University of Rio de Janeiro, HUCFF, and Graduate Program of Pathology, Rio de Janeiro, Brazil; Neurodegeneration and Repair Laboratory, UFRJ, Rio de Janeiro, Brazil.

Background: Intraorbital and intracerebral cavernous malformation (CM) lesions are considered independent entities. Purely cerebral CMs have variable biology with recent evidence depicting inflammation as an important player and a risk factor for aggressiveness. We describe a case of concomitant left intraaxial and extraaxial CMs, linked by the ipsilateral basal vein, where the extraaxial component has developed an aggressive behavior. Read More

J Neurosurg Sci 2019 Dec 23;63(6):656-660. Epub 2019 Jul 23.

Institute of Neurosurgery, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome, Italy.

Indocyanine green video angiography (ICG-VA) is a non-invasive, easy to use and very useful tool for various neurosurgical procedures. The first application was in neurovascular surgery, because it was born as an intravascular tracer for vessels visualization; this has been really useful in aneurysms, atero-venous malformations (AVMs) and dural fistulas surgery where identification, obliteration or patency of vessels is essential. Introduced in vascular neurosurgery since 2003, ICG-VA applications have broadened over time, both in vascular and in other neurosurgical fields. Read More

World Neurosurg 2019 Nov 19;131:e176-e185. Epub 2019 Jul 19.

Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan.

Background: The flow dynamics of the intracranial venous channels are fundamentally important for understanding intracranial physiology and pathophysiology. However, the method clinically applicable to the evaluation of the flow dynamics of the intracranial venous system has not been well described in the reported data. We have developed a new method to evaluate intracranial venous flow direction and velocity using 4-dimensional (4D) computed tomography angiography (CTA). Read More

Georgian Med News 2019 May(290):38-44

2Jerarsi Clinic, Tbilisi, Georgia.

The association of cerebral arteriovenous malformations (bAVM) and associated paranidal aneurysms, that is closely related to the AVM nidus, carry a high risk of rapture and re-rapture after initial hemorrhage. This association is consider as therapeutic challenge and supportive data about their natural history and best treatment modalities are still lacking. In this article we report our experience of their treatment. Read More

World Neurosurg 2019 Oct 9;130:306-312. Epub 2019 Jul 9.

Department of Neurosurgery, University of Wuhan, Zhongnan Hospital, Hubei, China. Electronic address:

Background: Certain cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) are difficult to access through transarterial or transvenous routes and may necessitate access through direct transorbital puncture of the superior ophthalmic vein (SOV) or the CS. However, to be successful, the accurate design of the puncture route and guidance are crucial. This study aimed to report our preliminary clinical experience using cone-beam computed tomography (CT) with real-time fluoroscopic overlays for image guidance during transorbital needle puncture. Read More

BMJ Case Rep 2019 Jul 10;12(7). Epub 2019 Jul 10.

Baptist Neurological Institute, Lyerly Neurosurgery, Jacksonville, Florida, USA.

We report an unusual case of a dural arteriovenous fistula (dAVF) presenting as acute neck pain and quadripareis in a 55-year-old previously healthy man. Imaging was suspicious for cervicomedullary venous thrombosis and angiography failed to show evidence of arteriovenous malformation or dAVF. The patient was started on warfarin for a presumed cervicomedullary venous thrombosis and there was a significant clinical improvement. Read More