Dural arteriovenous fistulas involving the inferior petrosal sinus: Angiographic findings in six patients

S. L. Barnwell, V. V. Halbach, C. F. Dowd, R. T. Higashida, G. B. Hieshima

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

We report the angiographic findings from six patients with intracranial dural arteriovenous fistulas of the inferior petrosal sinus and describe the clinical presentation, vascular anatomy, and embolization techniques used in the treatment of this disorder. Dural arteriovenous fistulas at this site are rare; of 105 patients diagnosed with this abnormality, only six had lesions involving the inferior petrosal sinus. The patients included three men and three women, ranging in age from 41 to 75 years. Patients presented with bruit, proptosis, abducens palsy, or loss of vision, and symptoms were present for up to 1 year prior to diagnosis. These presentations were similar to cavernous sinus arteriovenous fistulas. The arterial supply in all cases was from branches of the external carotid artery and in three cases from the meningohypophyseal trunk of the internal carotid artery. Venous drainage in four patients was via the cavernous sinus to the superior ophthalmic vein. The remaining two patients had drainage primarily to the jugular bulb. In four patients treatment was performed by introducing wire coils into the fistula from the transvenous route. This approach could be used even though the inferior petrosal sinus was thrombosed. One patient, treated early in the series, had only transarterial embolization with both liquid adhesives and particulate embolic agents. One patient had an asymptomatic fistula that was not treated. All patients were cured, as evidenced both angiographically and clinically during the follow-up period. Three patients experienced complications from angiography and treatment: two had transverse sinus thrombosis and one had a transient ischemic attack.

Original languageEnglish (US)
Pages (from-to)511-516
Number of pages6
JournalAmerican Journal of Neuroradiology
Volume11
Issue number3
StatePublished - 1990
Externally publishedYes

Fingerprint

Central Nervous System Vascular Malformations
Cavernous Sinus
Fistula
Drainage
Lateral Sinus Thrombosis
Intracranial Sinus Thrombosis
External Carotid Artery
Exophthalmos
Transient Ischemic Attack
Arteriovenous Fistula
Internal Carotid Artery
Adhesives
Blood Vessels
Veins
Anatomy
Angiography
Neck
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Barnwell, S. L., Halbach, V. V., Dowd, C. F., Higashida, R. T., & Hieshima, G. B. (1990). Dural arteriovenous fistulas involving the inferior petrosal sinus: Angiographic findings in six patients. American Journal of Neuroradiology, 11(3), 511-516.

Dural arteriovenous fistulas involving the inferior petrosal sinus : Angiographic findings in six patients. / Barnwell, S. L.; Halbach, V. V.; Dowd, C. F.; Higashida, R. T.; Hieshima, G. B.

In: American Journal of Neuroradiology, Vol. 11, No. 3, 1990, p. 511-516.

Research output: Contribution to journalArticle

Barnwell, SL, Halbach, VV, Dowd, CF, Higashida, RT & Hieshima, GB 1990, 'Dural arteriovenous fistulas involving the inferior petrosal sinus: Angiographic findings in six patients', American Journal of Neuroradiology, vol. 11, no. 3, pp. 511-516.
Barnwell, S. L. ; Halbach, V. V. ; Dowd, C. F. ; Higashida, R. T. ; Hieshima, G. B. / Dural arteriovenous fistulas involving the inferior petrosal sinus : Angiographic findings in six patients. In: American Journal of Neuroradiology. 1990 ; Vol. 11, No. 3. pp. 511-516.
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