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Clinical and angiographic characteristics of multiple dural arteriovenous shunts

Authors
 S.Y. Ha  ;  Y.S. Kwon  ;  B.M. Kim  ;  D.I. Kim  ;  D.J. Kim 
Citation
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.33(9) : 1691-1695, 2012 
Journal Title
 AMERICAN JOURNAL OF NEURORADIOLOGY 
ISSN
 0195-6108 
Issue Date
2012
MeSH
Adolescent ; Adult ; Aged ; Central Nervous System Vascular Malformations/diagnostic imaging* ; Central Nervous System Vascular Malformations/epidemiology* ; Cerebral Angiography/statistics & numerical data* ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Middle Aged ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Sensitivity and Specificity ; Young Adult
Keywords
Adolescent ; Adult ; Aged ; Central Nervous System Vascular Malformations/diagnostic imaging* ; Central Nervous System Vascular Malformations/epidemiology* ; Cerebral Angiography/statistics & numerical data* ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Middle Aged ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Sensitivity and Specificity ; Young Adult
Abstract
BACKGROUND AND PURPOSE: The pathogenesis and characteristics of multiple DAVSs are not well-known. The purpose of this study was to evaluate the angiographic and clinical characteristics of patients with multiple DAVSs with an emphasis on the pathomechanism. MATERIALS AND METHODS: One hundred seventy-nine patients with DAVS were reviewed. Patients with ≥ 2 fistulas at anatomically separate sites were included. Multiple DAVSs were categorized into synchronous (simultaneous multiplicity) or metachronous (temporal sequential development of multiplicity) types. The angiographic and clinical characteristics of these lesions were analyzed. RESULTS: Fourteen patients were diagnosed with multiple DAVSs (7.8%; synchronous, n = 7; metachronous, n = 7). Thirteen of the 14 patients showed CVR (93%, Borden type II/III). Multiple DAVSs were frequently associated with dural sinus thrombosis (71.4%, n = 10). Synchronous DAVSs developed in association with an occluded sinus (n = 5). De novo metachronous lesions developed in association with thrombosis of a previously patent dural sinus (n = 3) or reopening of an occluded sinus (n = 2). Multiplicity was associated with aggressive initial symptoms in 64.3% (n = 9). The newly developed lesions in the metachronous types were accompanied by hemorrhage (n = 1), neurologic deficit (n = 1), worsening of the initial benign symptoms (n = 2), and incidental detection (n = 3). The mean time interval between the initial diagnosis and de novo lesion detection was 31.3 ± 29.8 months (range, 12-92 months). CONCLUSIONS: Multiplicity of DAVSs is associated with poor angiographic and clinical prognosis, requiring an aggressive treatment and management strategy. Sinus thrombosis has a prominent role in the pathomechanism of DAVSs.
Files in This Item:
T201203347.pdf Download
DOI
22538077
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Young Sub(권영섭)
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Ha, Sam Youl(하삼열)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89425
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