Las malformaciones arteriovenosas durales (MAVDs) suponen aproximadamente del 10% al 15% del total de las malformaciones arteriovenosas (MAVs) intracraneales y muchas de ellas son poco sintomáticas o incluso asintomáticas. Las MAVDs que interesan al seno longitudinal superior (SLS) y la dura de la convexidad y hoz cerebrales, son relativamente infrecuentes, representando tan sólo entre el 7% Yel 11% de todas las MAVDs intracraneales, pero tienen interés neuroquirúrgico ya que sobre todo las dos primeras, muestran una especial tendencia a producir sangrado intracraneal debido a su frecuente asociación con drenaje venoso cortical.
Presentamos tres casos de MAVDs de la región del seno sagital-convexidad dural y dos de la hoz cerebral. Dos pacientes debutaron con hemorragia intracraneal y el resto desarrolló diversos déficits neurológicos. Tres pacientes fueron tratados con embolización por vía transarterial con diferentes resultados, uno se intervino quirúrgicamente y el otro rehusó tratamiento.
Se analizan las características clínicas, las peculiaridades angiográficas y el manejo terapéutico de las MAVDs de estas localizaciones.
Dural arteriovenous malformations (DAVMs) approximately represent 10% to 15% of all intracranial arteriovenous malformations (AVMs) and most of them are little symptomatic or even asymptomatic. DAVMs in the region of the superior sagittal sinus (SSS), dural convexity and the falx, are relatively unusual, accounting for 7% to 11% of all intracranial DAVMs, but have neurosurgical interest because they may present with an aggressive clinical course, particularIy the former two, carrying a high risk for intracranial bleeding related to their common association to cortical venous drainage.
We are presenting five patients with DAVMs of the sagittal sinus-dural convexity region (3 cases) and the cerebral falx (2 cases). Two patients presented with intracranial hemorrhage and the remaining developed neurological deficits. Three patients were treated by transarterial embolization with different results, one underwent surgical resection and the other one refused treatment.
The clinical course, the angiographic characteristics and the therapeutic management of patients with DAVMs in these locations are analyzed.
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