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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 Merrell Merrell Annex Trak Low Sneakers Cloudy cheap price free shipping buy cheap get authentic countdown package cheap online clearance new 100% guaranteed online OZMVf
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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, cheap sale official site cheap recommend NIKE Mens Air Max 2014 Dp Royal Blue/Elctrc Greenvoltblack LhjjDBk
at the level of the interventricular foramen producing unilateral ventricular dilatation. Shunting surgery was performed in 3 patients, 27,28 endoscopic third ventriculostomy in 2 (Case 2 and 29 ), whereas 3 patients (28%) were kept under close clinical observation without published surgical treatment. NIKE Womens Free RN CMTR 2017 Running Shoe Black/Blackanthraciteoff White free shipping 100% authentic 2zFwAhJI
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( Figure 2 ). For the remaining patients, the treatment was conservative.

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