61. Dural AVMの治療について:-cineangiographyの診断価値を含めて-

概要

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Intracranial dural arteriovenous malformation (dural AVM) is one of the most intractable cerebrovascular diseases. Recently, the interventional radiological technique has been available for this lesion, and the results have been reported to be satisfactory by some authors. Nonetheless, it is certain that many patients are troubled with remnants or recurrences of such lesions. At first, the authors stress the importance of evaluation of venous hemodynamics by means of cineangiography for reasonable selection of the method of treatment. This series includes two cases of spontaneous carotid-cavernous fistulas and two of dural AVM in the posterior fossa. They were divided into two types from the viewpoint of venous hemodynamics. The one is the slow-flow dural AVM, which manifests stagnation of contrast material in the superior ophthalmic vein in cases of spontaneous CCF or cortical venous reflux with sinus obstruction in cases of dural AVM in the posterior fossa. The second is fast-flow dural AVM, which shows no evidence of the above. In this series, Cases 1, 2 and 3 belong to the former type, Case 4 to the latter. In addition, the authors indicate the plan of treatment in our institute and discuss the application of radiotherapy. Finally, we also stress the postoperative follow-up examination by means of cineangiography.
The Japanese Society on Surgery for Cerebral Strokeの論文