Dural Arteriovenous Malformations

ABSTRACT

We have experienced 3 cases of dural arteriovenous malformation(AVM). Among them, 2 cases were traumatic and one case was congenital origin. The need for careful preoperative definition of all feeding vessels by selective cerebral angiography is stressed. Most frequent arterial feeders were the tentorial, middle meningeal, occipital artery and meningeal branches of vertebral artery. A complete neuroradiological investigation was essential for adequate treatment. Common symptoms were headache and troublesome tinnitus aurium. More serious neurological deficiencies may occur as result of disturbance in cerebral hemodynamics. Direct shunting of arterial blood into the transverse and sigmoid sinus caused a considerable increase of the sagital sinus pressure and elevation of intracranial pressure(ICP). ICP decreased following obliteration of dural AVM by muscle embolization with ligation of external carotid artery in one case. Operative isolation of the transverse sinus and sigmoid sinus by craniectomy or craniotomy and dural section is considered by far the most successful treatment. Purpose of this communication is, therefore, to describe the clinical and radiological features and various types of surgical procedure in 3 cases with dural AVM.