Bifrontal approach for clip ligation of bilateral ethmoidal dural arteriovenous fistulas: operative video

Document Type

Article

Abstract

Venous interruption through surgical clip ligation is the gold standard treatment for ethmoidal dural arteriovenous fistula (e-dAVF). Their malignant natural history is attributable to the higher predilection for retrograde cortical venous drainage. This video illustrates an e-dAVF in a 70-year-old man with progressive tinnitus and headache. Angiogram revealed bilateral e-dAVFs (Borden III-Cognard III) with one fistula draining into cavernous sinus and another to the sagittal sinus. A bifrontal craniotomy was utilized for venous interruption of both e-dAVFs. Postoperative angiography confirmed curative obliteration with no postoperative anosmia. Bilateral e-dAVFs are rare but can be safely treated simultaneously through a single craniotomy.The video can be found here: https://youtu.be/666edwKHGKc.

Medical Subject Headings

Aged; Cavernous Sinus (surgery); Central Nervous System Vascular Malformations (diagnosis, surgery); Craniotomy (methods); Humans; Ligation (methods); Male; Surgical Instruments (adverse effects)

Publication Date

4-3-2019

Publication Title

Neurosurgical focus

E-ISSN

1092-0684

Volume

46

Issue

Suppl_2

First Page

V14

PubMed ID

30939440

Digital Object Identifier (DOI)

10.3171/2019.2.FocusVid.18702

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