Middle meningeal arteriovenous fistulas: A rare and potentially high-risk dural arteriovenous fistula

Authors

Rami O. Almefty, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
M Yashar Kalani, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Andrew F. Ducruet, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
R Webster Crowley, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Cameron G. McDougall, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Felipe C. Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow

Document Type

Article

Abstract

BACKGROUND: Middle meningeal arteriovenous fistulas (MMAVFs) are rare lesions with a poorly established natural history. We report our experience with patients with MMAVFs who presented with intracranial hemorrhage. METHODS: We reviewed our prospectively maintained endovascular database for patients with MMAVFs, who were treated by embolization during a 15-year period. Hospital and outpatient medical records and imaging studies were reviewed. RESULTS: Nine patients with MMAVFs, who presented with intracranial hemorrhage, underwent embolization (mean age 60.3 years, range 21-76; four male and five female). Four patients presented after trauma and five after spontaneous hemorrhage. All nine patients were angiographically cured after embolization of the fistula with liquid embolic agents (n = 8) or coils (n = 1). There were no procedure-related complications. CONCLUSION: MMAVFs represent a rarely reported class of vascular lesions. They are typically associated with trauma, but also develop spontaneously, and may be associated with intracranial hemorrhage, which warrants classification of these lesions as high risk. Endovascular treatment is safe and effective and should be considered for these patients, particularly for those who have lesions with intracranial venous drainage.

Keywords

Arteriovenous, embolization, fistula, hemorrhage, meningeal, vascular

Publication Date

1-1-2016

Publication Title

Surgical neurology international

ISSN

2229-5097

Volume

7

Issue

Suppl 9

First Page

S219

Last Page

22

PubMed ID

27127711

Digital Object Identifier (DOI)

10.4103/2152-7806.179575

Recommended Citation

Almefty, Rami O.; Kalani, M Yashar; Ducruet, Andrew F.; Crowley, R Webster; McDougall, Cameron G.; and Albuquerque, Felipe C., "Middle meningeal arteriovenous fistulas: A rare and potentially high-risk dural arteriovenous fistula" (2016). Translational Neuroscience. 2129.
https://scholar.barrowneuro.org/neurobiology/2129