Search

Background and Purpose: Intracranial dural arteriovenous fistulas (DAVF) with cortical venous drainage are vascular malformations with high hemorrhagic risk. Their treatment may be complex and requires a multidisciplinary approach., Methods: We retrospectively report 38 observations of dural arteriovenous fistulas with cortical venous drainage from 1990 to 2001. There were 28 men and 10 women with a mean age of 57 years. Hemorrhage revealed the malformation in 24 cases (63%). The other patients had headache, neurological deficit, seizure or pulsating mass of the scalp. One patient was asymptomatic. All the patients had DAVF with cortical venous drainage and decision of treatment was in each case multidisciplinary., Results: Of the 38 patients, seven had no treatment for the following reasons: spontaneous occlusion of the malformation after hemorrhage, refusal of treatment, or poor neurological status at the admission. Thirty-one patients were treated and complete exclusion of the fistula was obtained in 30 cases. Endovascular occlusion of the fistula was performed in 14 patients, surgical clipping of the origin of the draining vein in 12 and combined treatment (surgical clipping after embolization of feeding arteries) in four. One patient had an untreated fistula despite several procedures., Conclusion: Complete exclusion of these malformations is mandatory because of the potential risk of hemorrhagic complications. The best treatment is the occlusion of the origin of the draining vein (endovascular or surgical) and requires multidisciplinary discussion.

Brain metastasis of choriocarinoma is uncommon. These tumors develop in women of childbearing age and commonly produce signs and symptoms of subarachnoid hemorrhage, intracerebral hemorrhage, or brain tumor. Diagnosis can be established by histologic study of operative swabs and bioassay of the patient's blood, urine and cerebrospinal fluid for chorionic gonadotropin. This condition is highly chemo- and radiosensitive. We report the case of a 36-year-old woman with intracranial neoplastic fistulae. Rupture occurred 3 days after spontaneous abortion at 3 months of pregnancy. The patient presented with hemiplegia, aphasia and unclear consciousness. Left fronto-parietal hematoma was diagnosed on the CT scan, and cerebral angiography showed an arteriovenous intracranial fistulae. The hematoma and angioma were surgically removed successfully. The histological examination showed a metastatic choriocarcinoma. Surgery was followed by chemotherapy and radiotherapy. After 6 years of follow-up, complete remission has been obtained.

Background and Purpose: Description and critical review of our procedure of definition of the target of irradiation of a cerebral arteriovenous malformations., Patients: and method. Fixation of the stereotactic frame, performing of stereotactic angiography and CT scanner were described, and the target including nidus and venous collectors of the a cerebral arteriovenous malformations defined., Conclusion: The use of several three-dimensional imaging techniques can improve and simplify the method of delineating target with a reduction of radio-induced complications.

We accomplished an anatomic study of the anastomotic veins of Trolard and Labbé in seven human cephalic segments with the objective to accurate its stretch and references to facilitate its preservation during surgical procedure. The relationship between the Trolard vein and motor cortex was also studied.

The authors, one century later, review the anatomical studies conducted by Launay, a student of Farabeuf, concerning the venous drainage of the face and neck. These studies were based on the analogy between the arterial system and the venous drainage of the external carotid territory. After describing the external carotid vein, the didactic and practical aspects of this study are emphasized.

Anatomic study of 20 injected specimens dissected under operating microscope allowed evaluation of anatomic site of Galen's ampulla, venous confluents of Galen's ampulla, and internal cerebral veins' terminations and their arterial connections in this region. Findings demonstrated that even the wall of the great vein of Galen was supplied by arterioles, as though it was vascularized in the same way as durameter.