Venous Embolization, CFS-Venous Fistula - 2021
A Novel Endovascular Therapy for CSF Hypotension Secondary to CSF-Venous Fistulas - AJNR
In this paper[1], the authors reported a consecutive case series of five patients with spontaneous intracranial hypotension secondary to CSF-venous fistula, which was successfully treated with endovascular transvenous Onyx embolization.
Study Specifics
- Journal: American Journal of Neuroradiology
- Publication history: May 2021
- Study type: Case series
- Interval: July 2020-August 2020
- Total patients: Five
- Male:Female - 4:1
- Mean age: 60 (SD: 10)
- Symptoms
- Headache: 5
- Tinnitus: 4
- Cognitive disturbances: 3
- Hearing loss: 2
- Lesion location
- All thoracic
- Median follow-up: 3 months (2-4 months)
- Approaches
- Trans-femoral vein: 4
- Trans-jugular vein: 1
- Target: Venous network surrounding the nerve root sleeve at the fistula level
- Embolic material: Onyx
- Improvement
- Complete: 4
- 50%: 1
Reference Points
- All the fistulas were localized using digital subtraction myelogram (DSM)
- Build a plug with 0.5 mL of Onyx 34, then embolize the fistula using 1 mL of Onyx 18
- Other treatment options: laminectomy, facetectomy, and ligation of the nerve root and associated veins.