Surgical treatment of tentorial dural arteriovenous fistulae located around the tentorial incisura

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• 作者：Taketo Hatano (1)
  Oliver Bozinov (2)
  Jan-Karl Burkhardt (2)
  Helmut Bertalanffy (3)
  
• 关键词：Dural arteriovenous fistulae (DAVF) ; Microsurgery ; Tentorial incisura ; Treatment ; Subtemporal approach
• 刊名：Neurosurgical Review
• 出版年：2013
• 出版时间：July 2013
• 年：2013
• 卷：36
• 期：3
• 页码：429-435
• 全文大小：240KB
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• 作者单位：Taketo Hatano (1)
  Oliver Bozinov (2)
  Jan-Karl Burkhardt (2)
  Helmut Bertalanffy (3)
  
  1. Department of Neurosurgery, University Hospital, Kyoto, Japan
  2. Department of Neurosurgery, University Hospital Z眉rich, Frauenklinikstrasse 10, 8091, Z眉rich, Switzerland
  3. Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany
  
• ISSN：1437-2320

文摘

Tentorial dural arteriovenous fistulae (DAVF) are relatively uncommon and are the most dangerous type of DAVF. Because of a high incidence of hemorrhage and subsequent neurological deficits, treatment is mandatory. A consecutive series of nine surgically treated patients with symptomatic tentorial DAVF were analyzed in this study. All lesions were located around the tentorial incisura and were treated microsurgically using a subtemporal approach in eight cases and a supracerebellar approach in one case. The dural bases of the lesions were located adjacent to the tentorial edge in six patients and the tentorial apex in three patients. Complete obliteration was achieved in all treated tentorial DAVF. In one patient, the torcular fistula remained untreated without cortical venous reflux. Postoperative asymptomatic temporal lobe hemorrhage was diagnosed in one patient with a tentorial apex DAVF; however, no new neurological symptoms were present after surgical treatment. The subtemporal approach for unilateral tentorial DAVF is a favorable and direct approach for the highly skilled surgeon. Perimesencephalic venous dilatation or varix is an important finding on MRI to help localize tentorial DAVF in the tentorial edge or apex.