OBJECT: Surgical intervention may be required if endovascular @entity887 is insufficient to completely obliterate intracranial dural arteriovenous @entity292 (DAVFs). The authors report their 14-year experience with 23 @entity1 harboring diverse intracranial DAVFs that required surgical intervention. METHODS: Between 1993 and 2007, 23 @entity1 underwent surgery for intracranial DAVFs. The following types of DAVFs were treated: superior petrosal sinus (in 10 @entity1 ); parietooccipital (in 3); confluence of sinuses and ethmoidal (in 2 each); and tentorial, falcine, occipital, transverse-sigmoid, superior sagittal, and cavernous sinuses (in 1 @entity1 each). In all cases, the authors' goal was to obliterate the DAVF venous outflow by direct surgical interruption of the leptomeningeal venous drainage. Transarterial @entity887 was used primarily as an adjunct to decrease flow to the DAVF prior to definitive treatment. RESULTS: Complete angiographic obliteration of the DAVF was achieved in all cases. There were no complications of @entity101 , @entity1188 , or perioperative @entity204 . There were no recurrences and no further clinical events (new @entity548 or focal @entity51 ) after a mean follow-up of 45 months. CONCLUSIONS: The authors' experience emphasizes the importance of occluding venous outflow to obliterate intracranial DAVFs. Those that drain purely through leptomeningeal veins can be safely obliterated by surgically clipping the arterialized draining vein as it exits the dura. Radical excision of the @entity292 is not necessary.

The role of surgery for high-grade intracranial dural arteriovenous XXXX : importance of obliteration of venous outflow.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity101 :: ('MESH:D006973', 'Disease') :: ['venous hypertension'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhages'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficits'] @entity887 :: ('MESH:D004617', 'Disease') :: ['embolization'] @entity292 :: ('MESH:D005402', 'Disease') :: ['fistula', 'fistulas'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['venous infarction'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity292 :: (MESH:D005402,Disease) :: ['fistulas']
