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Venous angioarchitectural features of intracranial dural arteriovenous shunt and its relation to the clinical course

Authors
 Na-Young Shin  ;  Young Sub Kwon  ;  Sam Yeol Ha  ;  Byung Moon Kim  ;  Dong Ik Kim  ;  Dong Joon Kim 
Citation
 Neuroradiology, Vol.55(9) : 1119-1127, 2013 
Journal Title
 Neuroradiology 
ISSN
 0028-3940 
Issue Date
2013
Abstract
INTRODUCTION: The aim of this study is to assess the relationship between the venous angioarchitectural features and the clinical course of intracranial dural arteriovenous shunt (DAVS) with cortical venous reflux (CVR). METHODS: With institutional review board approval, 41 patients (M:F = 24:17; median age, 52 years (range, 1-72 years), median follow-up; 1.5 years; partial treatment, n = 36) with persistent CVR were included. We evaluated the initial presentation and the incidence of annual morbidity (hemorrhage or new/worsened nonhemorrhagic neurological deficit (NHND)) according to the venous angiographic patterns-isolated venous sinus, occlusion of the draining sinus, direct pial venous drainage, pseudophlebitic pattern, venous ectasia, brisk venous drainage, and length of pial vein reflux-on digital subtraction angiography. Cox regression was performed to identify independent factors for clinical course. RESULTS: During 111.9 patient-years of follow-up, the overall annual morbidity rate was 11.6 % (mortality; n = 3, rate; 2.6 %/year). Hemorrhage occurred in five patients (12.2 %, rate; 4.5 %/year) and new/worsened NHND occurred in eight patients (19.5 %, rate; 7.2 %/year). Patients with isolated venous sinus, direct pial venous drainage, and pseudophlebitic pattern were associated with initial aggressive presentation. Venous ectasia was associated with initial hemorrhagic presentation. Brisk venous drainage was associated with initial benign presentation. Patients with isolated venous sinus showed a poor clinical course with a higher annual incidence of hemorrhage or new/worsened NHND (91.2 %/year vs 9.2 %/year; hazard ratio, 6.681; p = 0.027). CONCLUSIONS: Venous angioarchitectural features may be predictive of the clinical course of DAVSs. DAVS patients with isolated venous sinus may be especially at high risk for future aggressive clinical course.
Full Text
http://link.springer.com/article/10.1007%2Fs00234-013-1222-1
DOI
10.1007/s00234-013-1222-1
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김동익(Kim, Dong Ik)
김동준(Kim, Dong Joon) ORCID logo https://orcid.org/0000-0002-7035-087X
김병문(Kim, Byung Moon) ORCID logo https://orcid.org/0000-0001-8593-6841
신나영(Shin, Na Young)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87721
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