Spontaneous closure of non-cavernous sinus dural arteriovenous fistulas: A case series and systematic review of the literature,Journal of Neuroradiology

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Spontaneous closure of non-cavernous sinus dural arteriovenous fistulas: A case series and systematic review of the literature
Journal of Neuroradiology ( IF 3.0 ) Pub Date : 2020-09-09 , DOI: 10.1016/j.neurad.2020.09.002
Nobuo Kashiwagi ₁ , Koichi Miyazaki ₂ , Hiroto Takahashi ₃ , Kiyoshi Tsuji ₄ , Masahiro Fujiwara ₅ , Atsuko Arisawa ₅ , Hajime Nakamura ₆ , Haruhiko Kishima ₆ , Kazunari Ishii ₂ , Noriyuki Tomiyama ₅

Affiliation

Background and purpose

To report 9 new cases of non-cavernous sinus dural arteriovenous fistulas (NCS-DAVFs) that closed spontaneously and systematically review reports of other cases in the literature.

Material and methods

We performed a retrospective analysis of 9 cases from 2 institutions of NCS-DAVFs that closed spontaneously. Using PubMed and Scopus in accordance with the PRISMA guidelines, we systematically reviewed English language articles about NCS-DAVFs showing spontaneous closure.

Results

Review of the cases from 2 institutions identified 9 cases of NCS-DAVFs showing spontaneous closure in follow-up magnetic resonance angiography (MRA), and the systematic review of the literature yielded an additional 38 cases, which had been diagnosed by repeated arteriography. Collectively, the patients included 23 men and 24 women with a mean age of 54 years. The shunts were located in the transverse-sigmoid sinus in 24 cases (51%), anterior condylar confluence in 11, and other locations in 12. Based on the venous drainage pattern on arteriography, 27 cases (57%) were classified as low-risk NCS-DAVF (without cortical venous reflux) and 17 were classified as high-risk NCS-DAVF (with cortical venous reflux). Shunt closure was observed within 3 months in 17 cases (36%). Extrinsic predisposing factors for shunt closure were detected in 14 cases (30%). These included angiography in 7 cases, sinus recanalization in 4, development of sinus occlusion in 2, and sinus compression by a newly developed hematoma in 1.

Conclusion

Spontaneous closures of NCS-DAVFs can occur for both high- and low-risk types. One-third of these closures occur within 3 months.

中文翻译：

非海绵窦硬脑膜动静脉瘘的自发闭合：病例系列和文献系统评价

背景和目的

报告 9 例自发闭合的非海绵窦硬脑膜动静脉瘘 (NCS-DAVFs) 新病例，并系统回顾文献中其他病例的报告。

材料与方法

我们对来自 2 个自发关闭的 NCS-DAVF 机构的 9 例病例进行了回顾性分析。根据 PRISMA 指南使用 PubMed 和 Scopus，我们系统地回顾了关于 NCS-DAVF 显示自发闭合的英语文章。

结果

回顾 2 家机构的病例，发现 9 例 NCS-DAVF 在随访磁共振血管造影（MRA）中显示自发闭合，文献系统回顾发现另外 38 例，这些病例已通过重复动脉造影诊断。总的来说，这些患者包括 23 名男性和 24 名女性，平均年龄为 54 岁。24 例（51%）分流位于横乙状窦，11 例位于前髁汇合处，12 例位于其他位置。根据动脉造影的静脉引流模式，27 例（57%）被归类为低-风险 NCS-DAVF（无皮质静脉反流）和 17 例被归类为高风险 NCS-DAVF（有皮质静脉反流）。17 例（36%）在 3 个月内观察到分流管闭合。在 14 例 (30%) 中检测到分流闭合的外在诱发因素。其中包括 7 例血管造影、4 例鼻窦再通、2 例鼻窦闭塞和 1 例新发血肿压迫鼻窦。