Parallel transverse-sigmoid sinus harboring dural arteriovenous malformation. How to differentiate the pathological and normal sinus in order to treat and preserve patency and function.

An unusual case of dural arteriovenous malformation (DAVM) harboring a parallel transverse-sigmoid sinus (TSS) is presented. The patient had a 2-year history of left-sided pulsatile tinnitus in the left ear refractory to medical management. Angiography demonstrated a DAVM involving the left TSS.

Stent-jack technique in stent-assisted coiling of wide-neck aneurysms.

Objective: To describe a variant of the stent-assisted coiling technique in the endovascular treatment of aneurysms with a dome-to-neck ratio less than 1.5.

Clinical Presentation: This technique, named the stentjack technique, consisted of the deployment of a first coil before the delivery of a self-expandable stent across the aneurysm neck without detachment.

Selective endovascular treatment of a traumatic basilar aneurysm after endoscopic third ventriculostomy.

A 4-year-old girl suffered intraventricular and subarachnoid hemorrhage during endoscopic third ventriculostomy. Cerebral angiography revealed a traumatic basilar aneurysm secondary to basilar artery injury. The aneurysm was treated with selective endovascular embolization using Guglielmi detachable coils.

Endoarterial management of dural arteriovenous malformations with isolated sinus using Onyx-18: technical case report.

Objective: Anatomic and clinical cure of dural arteriovenous malformations (DAVM) with isolated sinus is difficult to achieve by endovascular means without previous surgical exposure. We propose a new management technique using a new liquid embolic agent (ethylene-vinyl alcohol copolymer [Onyx-18]; ev3 Inc., Plymouth, MN) via an endoarterial approach that would avoid surgical craniotomy.

Do leptomeningeal venous drainage and dysplastic venous dilation predict hemorrhage in dural arteriovenous fistula?

Background: The objective of this study was to correlate the presence of leptomeningeal venous drainage and dysplastic venous dilation with the risk of intracranial hemorrhage in DAVFs.

Methods: The subjects for this research were composed of 93 patients with DAVFs who were studied retrospectively with regard to therapeutic success and failure, who had undergone either neurosurgery or embolization or a combination of both methods, and whose disease was located in the cavernous sinus, the superior sagittal sinus, or the transverse-sigmoid sinus of the anterior fossa or of the tentorium. Also among these study subjects were patients who had had angiography done in at least 6 cranial vessels (external and internal carotid and vertebral arteries) before and after treatment and who had a minimum follow-up of 3 months.

Analysis of the best therapeutic alternative for intracranial dural arteriovenous malformations.

The material for this research consisted of 93 patients with dural arteriovenous malformations (DAVMs) who were studied retrospectively with regards to therapeutic success and failure, who had undergone either neurosurgery, or embolization or a combination of both methods and whose disease was located in the cavernous sinus, the superior sagittal sinus, the transverse-sigmoid sinus of the anterior fossa and the tentorium. Thus, it was possible to arrive at the following conclusions: treatment of the DAVMs must be indicated, jointly, by an interventionist neuroradiologist and a neurosurgeon; DAVMs of the transverse-sigmoid sinus were better treated when a combination of both methods was used; DAVMs of the tentorium were also better treated with a combined method; the endovascular method ensured only a 50% chance of therapeutic success for DAVMs of the superior sagittal sinus; DAVMs of the cavernous sinus are better treated when the endovascular method was used with a transvenous approach, relative to the transarterial approach.