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Treatment outcomes of intracranial dural arteriovenous fistulas of the transverse and sigmoid sinuses from a single institute in Asia.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Cho, Won-Sang Han, Jung Ho Kang, Hyun-Seung Kim, Jeong Eun Kwon, O-Ki Oh, Chang Wan Han, Moon Hee Chung, Young Seob
Spatial Coverage	Asia
Description	Author Affiliation: Cho WS ( Department of Neurosurgery, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Gangwon-do, Republic of Korea.)
Abstract	Intracranial dural arteriovenous fistulas (DAVFs) of the transverse and sigmoid sinuses (TSS) are rare in Asian populations. This study sought to evaluate the treatment outcomes of intracranial TSS DAVFs at a single Asian institute. Between 1989 and 2007, 122 patients presented to the Seoul National University Hospital with intracranial DAVFs; we performed a retrospective analysis of the 38 patients (31.1%) with TSS DAVFs. The common clinical presentations were headache (44.7%), tinnitus (39.5%), and intracranial hemorrhage (26.3%), and 71.1% had Borden type II or III lesions. Two patients were conservatively managed, two underwent surgery, and 34 were treated endovascularly with transarterial embolization (TAE), transvenous embolization (TVE), or both. The complete occlusion rate immediately after treatment was 50%. Of the 31 patients (81.6%) who underwent follow-up angiography, initial complete occlusion was achieved in 51.6%, and, at the last follow-up, the complete occlusion rate was 64.5%, with the surgery and TVE groups achieving 100% occlusion. The clinical cure rate was 34.2%, and 86.8% of patients had a favorable clinical outcome. However, all patients in both the surgery and TVE groups achieved a favorable clinical outcome. Four (26.7%) of 15 lesions with initially partial embolization showed delayed occlusion. Five patients (13.2%) exhibited clinical or angiographic signs of recurrence, and five patients had permanent complications. TSS DAVFs were less common than cavernous sinus DAVFs, unlike in Western countries, but the angiographic and clinical characteristics of TSS DAVFs were similar to those in Western countries. TSS DAVFs were successfully managed with different modalities, but both surgery and TVE were superior to conservative management or TAE.
File Format	HTM / HTML
ISSN	09675868
Issue Number	7
Volume Number	20
e-ISSN	15322653
Journal	Journal of Clinical Neuroscience
Language	English
Publisher	Elsevier
Publisher Date	2013-07-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Medicine Central Nervous System Vascular Malformations Therapy Cranial Sinuses Transverse Sinuses Adolescent Adult Aged Asia Child Child, Preschool Pathology Embolization, Therapeutic Methods Female Humans Infant Male Middle Aged Radiography Retrospective Studies Treatment Outcome Young Adult Journal Article
Content Type	Text
Resource Type	Article
Subject	Neurology Physiology (medical) Neurology (clinical) Surgery

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