Ultrasound diagnostics of a spontaneous arteriovenous fistula of the head and neck

Spontaneous superficial arteriovenous malformation causing pulsatile tinnitus: A case report

Superficial arteriovenous fistulae in the absence of other complicating features can be easily treatable with simple surgical excision. In this case, the patient's troublesome symptoms were completely cured with a straightforward procedure.

Comprehensive Treatment and Vascular Architecture Characteristic of High-Flow Vascular Malformations in Periorbital Regions

OBJECTIVE

This study analyzed the vascular architecture characteristics of high-flow vascular malformations (VMs) in periorbital regions, as well as the treatment and imaging prognosis of occlusion degree of the outflow veins.

METHOD

The clinical data of 24 patients with high-flow VMs in periorbital regions treated in our center from 2012 to 2019 were analyzed retrospectively, and the vascular architecture characteristics, treatment methods, and follow-up results were recorded.

RESULTS

The vascular architecture of high-flow VMs in periorbital regions which usually contained the intracranial feeding arteries (24/24,100.0%) and intracranial outflow veins (18/24, 75.0%). The average age of first diagnosis was 23 ± 16 years; the average age of treatment was 37 ± 10 years; the median follow-up time was 42.5 months. Twenty-four patients with high-flow VMs in periorbital regions had 58 treatments in all. The imaging cure was achieved in 6 patients by complete occlusion of outflow veins, and no recurrence was found by DSA. Eighteen patients who get incomplete occlusion of outflow veins were given 49 treatments, and 8 patients had imaging recurrence. Seven patients (7/24, 29.2%) had treatment-related complications in all.

CONCLUSIONS

Patients with high-flow VMs in periorbital regions are the most complex cases. The prognosis of patients whose outflow veins can be completely occluded is relatively good. The stepwise embolization while preserving organ function is advisable. Nevertheless, the incidence of treatment complications is still high.

Dural arteriovenous fistula is a rare cause of a pulsating noise in the ear (clinical observation and literature review)

The article describes the clinical manifestations of dural arteriovenous fistula, which is an abnormal communication between the arteries of the dura mater and venous sinuses or cortical veins. Information on the etiology and pathogenesis of such malformation in domestic literature is limited to a few publications. Diagnosis is based on the identification of visual (pulsation of the earlobe) and acoustic phenomena in the patient, the presence of neuroimaging, in particular MR angiography, a shunt between the posterior auricular artery (branch of the external carotid artery) and the dural venous sinuses. The best treatment method is neurosurgical intervention using endovascular surgery.