Türk Nöroşirürji Dergisi 2021 , Vol 31 , Num 2
Endovascular Treatment in Anterior Cranial Fossa Dural Arteriovenous Fistulas
Samet DİNÇ1,Ömer Selçuk ŞAHİN2,Gülce GEL3,Mehmet Erhan TÜRKOĞLU3
1Bayburt Devlet Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, Bayburt, Türkiye
2Binali Yıldırım Üniversitesi Mengücek Gazi Eğitim ve Araştırma Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, Erzincan, Türkiye
3Sağlık Bilimleri Üniversitesi Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi , Beyin ve Sinir Cerrahisi Kliniği, Ankara, Türkiye
Dural arteriovenous fistulas are arteriovenous shunts located in the dural wall of the venous sinuses or the enlarged layers of the dura. Intracranial dural arteriovenous fistulas are more common in men (80-85%). 10-15% of all intracranial vascular malformations are dural arteriovenous fistulas, and only 10% seem to be in the anterior fossa. Fistulas of the anterior cranial fossa are usually bilateral. Less frequently, the fistula is fed unilaterally from the anterior ethmoidal branches of the ophthalmic artery, and rarely by the posterior ethmoidal branches. Unusually, minor branches originating from the ophthalmic artery can also feed these fistulas. In more than 75% of the cases, drainage to the superior sagittal sinus through the frontal cortical veins is typical. Patients can be asymptomatic or present to the hospital with symptoms ranging from headaches, seizures, and ocular symptoms, to fatal bleeding. The incidence of hemorrhage is 79% and higher than the risk of bleeding associated with the other regions (15%). Current treatment options are resection, endovascular therapy, or stereotaxic radiosurgery. Anterior fossa dural arteriovenous fistulas tend to have a malignant drainage pattern. Due to their relationship with high bleeding and neurological morbidity, they should be treated regardless of whether they are symptomatic. Anahtar Kelimeler : Anterior cranial fossa, Arteriovenous fistula, Endovascular treatment, Ophthalmic artery