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View this table:

Table 1. Own Series of 17 Patients With 18 Episodes of Vascular Complications Attributable to a DVA

View this table:

Table 1. Continued

Figure 1. Pathomechanisms of symptomatic DVAs. Based on imaging findings and clinical symptoms, two major pathomechanisms could be identified: mechanical and flow-related. Patients in whom neither pathomechanism was observed were grouped separately as idiopathic or spontaneous. Although mechanical complications lead either to hydrocephalus or to vessel–nerve conflicts, flow-related mechanisms could be further subdivided into those that were related to an increase in inflow into the DVA or to an obstruction of the outflow.

Mechanical complications were considered when some component of the DVA (typically the draining collector vein) compressed an intracranial structure (parenchyma, cranial nerves, ventricles, or bone), thereby producing compressive symptoms that could be documented by imaging. We found 2 patients from our series and 12 additional cases from the literature ( Table 2 ).

View this table:

Table 2. Findings in All Patients Reported in the Literature With ‘Mechanical’ Complications Related to the DVA

The mean age of patients in this group was 30 years with a range from 1 to 62 years; there was no gender predominance (male:female=7:7). Most cases were related to the collecting vein of a posterior fossa DVA (n=9 [64.3%]); in 42.8% of cases, the venous collector of the DVA was dilated. There was no relation between compressive symptoms and the size of the drained medullary zone. A detailed description of the clinical symptoms can be seen in Tables 1 and 2 best seller for sale free shipping 2014 new Kenneth Cole New York Mens Initial Point Sneaker Rust sale big sale buy cheap view buy cheap discount 7ijl22Zzz
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. In brief, obstructive hydrocephalus (n=7 [50%]) and neurovascular nerve compression syndromes (n=6 [42.8%]), being trigeminal neuralgia, facial hemispasm, or tinnitus, were the most common findings. The structure most typically compressed was the mesencephalic aqueduct (n=6 [42.8%]) followed by the trigeminal nerve (n=3 [21.4%]) and the acousticofacial complex (n=3 [21.4%]). The orbital contents (Case 1) and the interventricular foramen were compressed in one patient each.

The patients presenting with hydrocephalus had the occlusion at the level of the aqueduct (n=6) or, in a single case, sale 2015 new pre order sale online adidas Tubular Runner Weave clearance 2015 new uRLCi3u
at the level of the interventricular foramen producing unilateral ventricular dilatation. Shunting surgery was performed in 3 patients, latest collections sale online cheap 2015 new Skechers Mens Terrabite Oxford Navy/Charcoal prices cheap price manchester great sale outlet genuine WkM6wEor
endoscopic third ventriculostomy in 2 (Case 2 and 29 ), whereas 3 patients (28%) were kept under close clinical observation without published surgical treatment. 30,31 Three patients with nerve compression underwent decompressive treatment with excellent results PLUM PLUM Knee High Ruffle Boots Pewter Lurex cheap USA stockist buy cheap store new arrival for sale 2014 for sale ZuKK4
( Figure 2 ). For the remaining patients, the treatment was conservative.

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