Article Figures & Data
Figures
- Fig 1.
Patient 1. A, Angiogram of right internal carotid injection, anteroposterior view, shows a conglomerate of abnormally dilated vessels at the A1/A2 junction of the right ACA with a venous aneurysm (arrow). The lesion drains into the left sigmoid sinus and sphenoparietal sinus contralaterally via the right frontal basal vein and left tentorial sinus. B, Superselective angiography shows an arteriovenous fistula. C, Control angiogram of the right internal carotid injection after Onyx embolization, anteroposterior view, shows that the fistula was obliterated completely.
- Fig 2.
Patient 2. A, Angiogram of left internal carotid injection shows a pial AVF supplied by the left distal ACA with a giant venous aneurysm. B, Angiogram of the left internal carotid injection after the procedure shows that the fistula is occluded partially. C, Control angiogram at 4-month follow-up shows the fistula thrombosis spontaneously.
- Fig 3.
Patient 3. A, T2-weighted MR imaging of the head at the level of the midbrain shows giant flow-void signal intensity in the interpeduncular cistern. B, Anteroposterior view of the left vertebral artery injection demonstrates that the fistula is supplied by the primitive trigeminal artery and drained into the basal vein of Rosenthal, with an associated venous varix. C, After coil embolization, anteroposterior view of the left vertebral artery injection demonstrates incomplete disconnection of the fistula by the coils. D, Follow-up angiogram obtained at 7 months shows spontaneous occlusion of the fistula with preserved patency of the basilar artery. E, Disappearance of the venous varix on follow-up T2-weighted MR imaging.
Tables
Patients with BAVFs treated with endovascular techniques
Patient No. Age/Sex Location Presentation Feeding Arteries Treatment and Immediate Outcome* Follow-up 1 n7/M Gyrus rectus region ICH Junction of A1 and A2 Onyx-34, complete 3 2 26/F Posterior aspect of interhemispheric fissure Headaches Distal ACA Detachable coils, incomplete 4 3 7/M Interpeduncular cistern Incidental Primitive trigeminal artery Detachable coils, incomplete 7 4 40/M Sylvian fissure ICH MCA, 3 arterial connections (IV), detachable coils, complete 7 5 14/M Anterior aspect of interhemispheric fissure Seizure A2 segment of ACA (II), detachable coils, complete 3 6 7/M Posterior aspect of interhemispheric fissure Headaches P4 segment of PCA Detachable coils, complete 12 7 35/M Third ventricle ICH Posterior medial choroidal arteries of PCAs Detachable coils and 34% n-BCA, complete 6 8 22/F Quadrigeminal cistern ICH P3–P4 segment of PCA Fiber coils, incomplete 3 9 2/M Anterior aspect of interhemispheric fissure Incidental A2 segment of ACA Detachable coils, complete 6 Note:—BAVFs indicate brain arteriovenous fistulas; R, right; L, left; F, female; M, male; MCA, middle cerebral artery; PCA, posterior cerebral artery; ACA, anterior cerebral artery; n-BCA, n-butyl cyanoacrylate; ICH, intracranial hemorrhage; II, IV, 2 times and 4 times.
* All patients were cured on follow-up.
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