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Research ArticleBRAIN

Tortuous, Engorged Pial Veins in Intracranial Dural Arteriovenous Fistulas: Correlations with Presentation, Location, and MR Findings in 122 Patients

Robert Willinsky, Mayank Goyal, Karel terBrugge and Walter Montanera
American Journal of Neuroradiology June 1999, 20 (6) 1031-1036;
Robert Willinsky
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Mayank Goyal
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Karel terBrugge
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Walter Montanera
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    fig 1.

    Representative cases showing severity of PPP.

    A–C, Examples of mild (A), moderate (B), and severe (C) PPP on lateral views of the venous phase of cerebral angiogram. Mild PPP has small tortuous collateral veins (short wide arrows, A and B) with slight irregularity of the cortical veins (long thin arrows, A and B). These changes are more evident in moderate PPP and more dramatic in severe PPP.

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    fig 2.

    60-year-old woman with dementia.

    A, Axial T2-weighted MR image shows hydrocephalus and a plethora of prominent subarachnoid vessels (arrows).

    B and C, Lateral views of the arterial (B) and venous (C) phases of left occipital angiogram show a complex DAVF involving the distal transverse sinus with retrograde flow in an anomalous parietal dural venous sinus (arrow, B) and RLVD (arrows, C).

    D, Lateral view of the venous phase of right internal carotid angiogram shows severe PPP.

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    fig 3.

    51-year-old man with dementia after removal of an acoustic neuroma.

    A, Lateral view of a right occipital angiogram shows a DAVF involving an occluded right transverse sinus with retrograde flow in the superior sagittal sinus (open arrow) and RLVD (solid arrows) into the straight sinus and basal vein of Rosenthal.

    B and C, Lateral views of venous phase of left internal carotid angiograms done before (B) and 4 years after (C) treatment show less marked PPP at follow-up, consistent with clinical improvement.

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    fig 4.

    Age distribution of 130 patients with intracranial DAVF

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    Table 1:

    Relationship of presentation and severity of pseudophlebitic pattern (PPP) (n = 122 patients)

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    Table 2:

    Relationship of location, retrograde leptomeningeal venous drainage (RLVD) and pseudophlebitic pattern (PPP) (n = 122 patients)

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    Table 3:

    Relationship between presentation, location, and severity of pseudophlebitic pattern (PPP) in five patients without retrograde leptomeningeal venous drainage

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American Journal of Neuroradiology
Vol. 20, Issue 6
1 Jun 1999
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Cite this article
Robert Willinsky, Mayank Goyal, Karel terBrugge, Walter Montanera
Tortuous, Engorged Pial Veins in Intracranial Dural Arteriovenous Fistulas: Correlations with Presentation, Location, and MR Findings in 122 Patients
American Journal of Neuroradiology Jun 1999, 20 (6) 1031-1036;

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Tortuous, Engorged Pial Veins in Intracranial Dural Arteriovenous Fistulas: Correlations with Presentation, Location, and MR Findings in 122 Patients
Robert Willinsky, Mayank Goyal, Karel terBrugge, Walter Montanera
American Journal of Neuroradiology Jun 1999, 20 (6) 1031-1036;
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  • Endovascular management of six simultaneous intracranial dural arteriovenous fistulas in a single patient
  • Angioarchitecture of Brain AVM Determines the Presentation with Seizures: Proposed Scoring System
  • Endovascular management of six simultaneous intracranial dural arteriovenous fistulas in a single patient
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  • Whole-Brain Perfusion CT Patterns of Brain Arteriovenous Malformations: A Pilot Study in 18 Patients
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  • Natural History of Dural Arteriovenous Shunts
  • MR Angiography of Dural Arteriovenous Fistulas: Diagnosis and Follow-Up after Treatment Using a Time-Resolved 3D Contrast-Enhanced Technique
  • Current theory in imaging of intracranial vascular disease
  • Clinical Course of Cranial Dural Arteriovenous Fistulas With Long-Term Persistent Cortical Venous Reflux
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