Frontal Ethmoidal Dural Arteriovenous Fistula: 2-Dimensional Operative Video.

Department

Neurosurgery

Document Type

Article

Abstract

Anterior cranial fossa dural arteriovenous fistulas (DAVFs) are an infrequent subtype of cranial DAVFs. These lesions are most commonly derived from the ophthalmic artery. These lesions are often best treated utilizing endovascular embolization; however, this modality can be challenging because of the difficulty in catheterizing the ophthalmic or ethmoidal arteries. Surgical intervention is therefore indicated and requires approaching the proximal portion of the drainage vein to appropriately obliterate the fistulous point. For ethmoidal DAVFs, this is frequently along the dura of the cranial base adjacent to the cribriform plate. This patient had a right frontal hematoma with a typical ethmoidal DAVF. The fistula was exposed through a frontal craniotomy, and the ethmoidal branch was identified at the fistulous point. Intraoperative angiography was used to test for obliteration, which revealed a contralateral DAVF. The contralateral fistula was then obliterated in a similar manner, demonstrated on a second intraoperative angiogram. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.

Publication Date

7-1-2020

Publication Title

Oper Neurosurg (Hagerstown)

ISSN

2332-4260

Volume

19

Issue

1

First Page

46

Last Page

46

PubMed ID

32171010

Digital Object Identifier (DOI)

10.1093/ons/opaa051

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