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KMID : 1005420070090020143
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Journal of Cerebrovascular and Endovascular Neurosurgery
2007 Volume.9 No. 2 p.143 ~ p.147
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Treatment of Superior Sagittal Sinus Dural Arteriovenous Fistula
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Kim Tae-Yeon
Lee Il-Woo
Lee Hyung-Jin
Yang Ji-Ho
Lee Jin-Seok
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Abstract
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Objectives: Dural arteriovenous fistulas (dAVFs) at the superior sagittal sinus (SSS) are very rare. Endovascular treatment alone often fails to eliminate the fistula because of the midline location of the SSS, the eloquent venous drainage and the multiple bilateral arterial feeders. Surgical extirpation of dAVFs is not recommended in all cases because of the considerable risks involved. We report here on a case of dAVF at the SSS with patent sinus drainage and retrograde leptomeningeal venous drainage, and this was selectively disconnected using an aneurysmal clip under intraoperative Doppler monitoring. The neurological symptoms vanished during the 2 years of follow-up, and no further progression of the dAVF has been found. The methods of converting aggressive dAVFs to benign forms are relatively safe and simple. Therefore, this simple and effective method could be recommended for older aged patients with high intraoperative risk.
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KEYWORD
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Superior sagittal sinus, Dural arteriovenous fistula, Intraoperative Doppler
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