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Cavernous Dural Arteriovenous Fistulas: Transorbital Cavernous Sinus Direct Puncture

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Intracranial and Spinal Dural Arteriovenous Fistulas

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Abstract

Cavernous sinus dural arteriovenous fistulas (CSDAVFs) are abnormal connections between the meningeal branches of the external and/or internal carotid artery and the walls of the cavernous sinus. The most common clinical presentation of CSDAVFs are symptoms resulting from venous hypertension, such as exophthalmos, chemosis, painful eyeball, and visual loss. Progressive visual impairment, elevated intraocular pressure, debilitating ocular symptoms, and leptomeningeal venous drainage are indications for invasive therapy. Endovascular management is currently the treatment of choice and aims to occlude the arteriovenous shunting point, which is most often achieved by obliterating the involved segment of the cavernous sinus. In most cases, transvenous access through the inferior petrosal sinus is the approach of choice. However, this strategy is not always feasible, and alternative approaches can be used, such as direct transorbital puncture. This chapter aims to describe this technique in detail.

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Authors and Affiliations

  1. Neurology and Neurosurgery Service, Passo Fundo, RS, Brazil

    Luciano Bambini Manzato & José Ricardo Vanzin

  2. Neurovascular Institute, Belo Horizonte, MG, Brazil

    Felipe Padovani Trivelato, Alexandre Cordeiro Ulhôa & Marco Túlio Salles Rezende

Authors
  1. Luciano Bambini Manzato
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  2. José Ricardo Vanzin
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  3. Felipe Padovani Trivelato
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  4. Alexandre Cordeiro Ulhôa
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  5. Marco Túlio Salles Rezende
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Editors and Affiliations

  1. Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

    Xianli Lv

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Manzato, L.B., Vanzin, J.R., Trivelato, F.P., Ulhôa, A.C., Rezende, M.T.S. (2022). Cavernous Dural Arteriovenous Fistulas: Transorbital Cavernous Sinus Direct Puncture. In: Lv, X. (eds) Intracranial and Spinal Dural Arteriovenous Fistulas. Springer, Singapore. https://doi.org/10.1007/978-981-19-5767-3_10

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  • DOI: https://doi.org/10.1007/978-981-19-5767-3_10

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-5766-6

  • Online ISBN: 978-981-19-5767-3

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