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Microsurgical treatment of the radicular arteriovenous fistula with multiple feeders at the craniocervical junction. 颅颈交界处多喂食器根状动静脉瘘的显微外科治疗。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID2526
Satoshi Matsuo, Kenta Hara, Akifumi Yokomizo, Toru Hasegawa, Hidenori Yoshida, Kiyotaka Fujii
{"title":"Microsurgical treatment of the radicular arteriovenous fistula with multiple feeders at the craniocervical junction.","authors":"Satoshi Matsuo, Kenta Hara, Akifumi Yokomizo, Toru Hasegawa, Hidenori Yoshida, Kiyotaka Fujii","doi":"10.3171/2025.7.FOCVID2526","DOIUrl":"10.3171/2025.7.FOCVID2526","url":null,"abstract":"<p><p>Arteriovenous fistula of the craniocervical junction is a rare vascular malformation. Although a precise understanding of its angioarchitecture is essential for appropriate and curative treatment, a preoperative diagnosis can be difficult owing to its complexity. Intraoperative findings may provide more clues to the definitive diagnosis. In this video, the authors present an operative technique for exposing a radicular arteriovenous fistula at the craniocervical junction fed by the radicular and spinal pial arteries draining into the common intradural vein. This fistula was definitively diagnosed based on intraoperative findings and treated by disconnecting the common draining vein. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2526.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V13"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microsurgical treatment of sacral spinal dural arteriovenous fistula. 骶脊膜动静脉瘘的显微外科治疗。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID25112
Hana Hallak, Ananth K Vellimana
{"title":"Microsurgical treatment of sacral spinal dural arteriovenous fistula.","authors":"Hana Hallak, Ananth K Vellimana","doi":"10.3171/2025.7.FOCVID25112","DOIUrl":"10.3171/2025.7.FOCVID25112","url":null,"abstract":"<p><p>Sacral spinal dural arteriovenous fistulas (dAVFs) are rare vascular lesions. In this video, the authors describe the case of a 71-year-old female who presented with profound myelopathy secondary to a sacral spinal dAVF. Identification of these lesions requires a high index of clinical suspicion, and a complete spinal angiography study including evaluation of the pelvic vasculature is necessary to detect the arteriovenous shunting. The video demonstrates a nuanced approach to angiographic detection of the dAVF and identification of the fistulous point at the left S1-2 neural foramen, and subsequent treatment with microsurgical selective venous disconnection. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID25112.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V12"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preoperative embolization and craniotomy for the treatment of a tentorial dural arteriovenous fistula. 术前栓塞开颅治疗小脑幕硬脑膜动静脉瘘。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID2597
Quang Nguyen, Nikolaos Mouchtouris, Yin Hu, Sepideh Amin-Hanjani
{"title":"Preoperative embolization and craniotomy for the treatment of a tentorial dural arteriovenous fistula.","authors":"Quang Nguyen, Nikolaos Mouchtouris, Yin Hu, Sepideh Amin-Hanjani","doi":"10.3171/2025.7.FOCVID2597","DOIUrl":"10.3171/2025.7.FOCVID2597","url":null,"abstract":"<p><p>This is a video presentation of a complex tentorial arteriovenous fistula that required multimodal treatment with preoperative embolization followed by craniotomy for clip ligation with several teaching points. A Cognard type IV fistula has multiple arterial feeders and direct cortical venous drainage with venous ectasia. A multimodal approach was required, consisting of endovascular embolization of occipital feeders followed by tailored craniotomy for clip ligation of the venous outflow of the fistula. The video discusses important nuances for the successful treatment of complex arteriovenous fistulas while minimizing morbidity. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2597.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V5"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Staged transarterial and transvenous embolization of a high-grade ruptured tentorial dural arteriovenous fistula. 分阶段经动脉和经静脉栓塞治疗高度破裂的幕脑膜动静脉瘘。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID2593
William M Burns, Santiago Mendoza-Ayus, Allison Young, Pablo V Barrera, Gurkirat S Kohli, Prasanth Romiyo, Rohin Singh, Tarun Bhalla, Matthew T Bender, Thomas K Mattingly, Vincent N Nguyen
{"title":"Staged transarterial and transvenous embolization of a high-grade ruptured tentorial dural arteriovenous fistula.","authors":"William M Burns, Santiago Mendoza-Ayus, Allison Young, Pablo V Barrera, Gurkirat S Kohli, Prasanth Romiyo, Rohin Singh, Tarun Bhalla, Matthew T Bender, Thomas K Mattingly, Vincent N Nguyen","doi":"10.3171/2025.7.FOCVID2593","DOIUrl":"10.3171/2025.7.FOCVID2593","url":null,"abstract":"<p><p>Tentorial dural arteriovenous fistulas (TDAVFs) are rare but high-risk lesions due to frequent deep venous drainage. A 77-year-old woman presented with a ruptured, high-grade (Borden III, Cognard IV, Zipfel 3S) TDAVF at the pontomesencephalic junction. Angiography revealed feeders from the left middle meningeal artery, occipital artery, and meningohypophyseal trunk with tortuous venous drainage into a partially thrombosed varix. Initial transarterial <i>N</i>-butyl cyanoacrylate (<i>N</i>-BCA) embolization was incomplete. Definitive cure was achieved with transvenous coiling. Postoperatively, the patient was neurologically stable, and follow-up angiography revealed no further arteriovenous shunting, demonstrating how staged embolization can lead to curing TDAVFs with complex angioarchitecture. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2593.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V4"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Far-lateral craniotomy for obliteration of foramen magnum dural arteriovenous fistula. 远外侧开颅术封堵硬膜大孔动静脉瘘。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID2579
Michael G Brandel, Jeffrey A Steinberg
{"title":"Far-lateral craniotomy for obliteration of foramen magnum dural arteriovenous fistula.","authors":"Michael G Brandel, Jeffrey A Steinberg","doi":"10.3171/2025.7.FOCVID2579","DOIUrl":"10.3171/2025.7.FOCVID2579","url":null,"abstract":"<p><p>A 63-year-old woman with a history of stroke underwent further workup. MRI revealed a region of asymmetrical ASL hyperintensity near the right hypoglossal canal. Angiogram revealed a left foramen magnum region dural arteriovenous fistula supplied by a left V4 vertebral artery branch, with early draining veins into the skull base and left sigmoid sinus. Attempts were made to catheterize the fistula, but it was not amenable to endovascular intervention. A far-lateral craniotomy with C1 hemilaminectomy was performed, with obliteration confirmed on postoperative DSA. At 2-year follow-up, the patient remained at her neurological baseline with no evidence of recurrence. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2579.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V17"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microsurgical obliteration of a superior petrosal dural arteriovenous fistula presenting with a symptomatic brainstem cavernous malformation. 以症状性脑干海绵状畸形为表现的岩膜上硬脑膜动静脉瘘显微手术闭塞。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID2553
Ryan M Naylor, Alexander Pais, Stephen Graepel, Giuseppe Lanzino, Michael J Link
{"title":"Microsurgical obliteration of a superior petrosal dural arteriovenous fistula presenting with a symptomatic brainstem cavernous malformation.","authors":"Ryan M Naylor, Alexander Pais, Stephen Graepel, Giuseppe Lanzino, Michael J Link","doi":"10.3171/2025.7.FOCVID2553","DOIUrl":"10.3171/2025.7.FOCVID2553","url":null,"abstract":"<p><p>In this video, the authors present the microsurgical treatment of a superior petrosal dural arteriovenous fistula (dAVF) associated with a symptomatic hemorrhagic brainstem cavernous malformation in a 38-year-old male. The patient underwent a retrosigmoid craniotomy for cavernoma evacuation and fistula disconnection. Intraoperative indocyanine green angiography revealed cortical venous reflux not evident on catheter angiography, prompting reclassification to a higher-grade fistula. Postoperatively, the patient returned to neurological baseline, and follow-up imaging confirmed complete fistula obliteration, cavernoma resection, and new appearance of a developmental venous anomaly (DVA). This case highlights the dynamic nature of dAVF venous drainage and illustrates the rare co-occurrence of dAVF, DVA, and brainstem cavernoma. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2553.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V2"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Midline supracerebellar infratentorial approach with clip occlusion of a straight sinus dural arteriovenous fistula. 中线小脑上幕下入路夹闭直窦硬脑膜动静脉瘘。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID2586
Anna L Huguenard, Visish M Srinivasan, Mohamed A Labib, Jakub Godzik, Michael T Lawton
{"title":"Midline supracerebellar infratentorial approach with clip occlusion of a straight sinus dural arteriovenous fistula.","authors":"Anna L Huguenard, Visish M Srinivasan, Mohamed A Labib, Jakub Godzik, Michael T Lawton","doi":"10.3171/2025.7.FOCVID2586","DOIUrl":"10.3171/2025.7.FOCVID2586","url":null,"abstract":"<p><p>Straight sinus dural arteriovenous fistulas (dAVFs), classified as tentorial type 2, can be approached with a torcular craniotomy and supracerebellar infratentorial approach, with gravity retraction from a sitting position optimizing the view. This video presents the case of a man in his early 60s with a thunderclap headache. Imaging showed a subarachnoid hemorrhage, and angiography confirmed a straight sinus dAVF. Endovascular embolization reduced flow, but further obliteration with surgical ligation was required. Intraoperative identification of the arterialized veins led to the fistula, and 2 efferent veins were clipped and divided. The patient tolerated the procedure well without new deficits, and angiography confirmed dAVF occlusion. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2586.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V10"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical management of petrosal dural arteriovenous fistulas. 硬脑膜岩动静脉瘘的外科治疗。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID2598
Ari D Kappel, Sahin Hanalioglu, Anil Can, David I Bass, Rose Du
{"title":"Surgical management of petrosal dural arteriovenous fistulas.","authors":"Ari D Kappel, Sahin Hanalioglu, Anil Can, David I Bass, Rose Du","doi":"10.3171/2025.7.FOCVID2598","DOIUrl":"10.3171/2025.7.FOCVID2598","url":null,"abstract":"<p><p>Dural arteriovenous fistulas (DAVFs) are rare with a low incidence. Tentorial DAVFs account for 10%-15% of all intracranial DAVFs and are associated with an aggressive clinical course. Petrosal DAVFs are a subtype of tentorial DAVFs and account for approximately 26% of tentorial DAVFs. They are supplied by the marginal tentorial artery or external carotid artery branches and drain into the petrosal vein and/or the superior petrosal sinus. Petrosal DAVFs may be challenging to treat endovascularly, while surgical management is often relatively safe and effective. Here the authors present two cases of surgically managed petrosal DAVFs. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2598.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V19"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Superior ophthalmic vein cutdown and craniotomy for sylvian vein access in the treatment of a bilateral spontaneous indirect carotid-cavernous fistula. 眼上静脉切开术治疗双侧自发性间接颈海绵状静脉瘘。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID25103
Ross Greenberg, James Feghali, Risheng Xu, Christopher M Jackson, Justin M Caplan, Nicholas R Mahoney, Judy Huang, Rafael J Tamargo, L Fernando Gonzalez
{"title":"Superior ophthalmic vein cutdown and craniotomy for sylvian vein access in the treatment of a bilateral spontaneous indirect carotid-cavernous fistula.","authors":"Ross Greenberg, James Feghali, Risheng Xu, Christopher M Jackson, Justin M Caplan, Nicholas R Mahoney, Judy Huang, Rafael J Tamargo, L Fernando Gonzalez","doi":"10.3171/2025.7.FOCVID25103","DOIUrl":"10.3171/2025.7.FOCVID25103","url":null,"abstract":"<p><p>The authors discuss the first reported case of bilateral spontaneous indirect carotid-cavernous fistula (CCF) treated by a hybrid open-endovascular approach bilaterally. A 74-year-old man presented to the emergency department following 1 month of progressive right-eye proptosis with increased intraocular pressure. Cerebral angiography confirmed bilateral indirect type D CCF. Attempts to access the cavernous sinus through the petrosal sinuses were unsuccessful. The right-sided CCF was successfully treated via surgical exposure of the superior ophthalmic vein for endovascular deployment of coils and liquid embolic agent. The left-sided CCF was similarly treated after gaining cavernous sinus access via craniotomy to catheterize the left sylvian vein. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID25103.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V6"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endovascular occlusion of external carotid artery: internal jugular vein fistula via direct transcranial access to transverse-sigmoid sinus. 颈外动脉血管内闭塞：颈内静脉瘘经直接经颅进入横乙状窦。
Neurosurgical focus: Video Pub Date : 2025-10-01 DOI: 10.3171/2025.7.FOCVID2537
Kautilya R Patel, William E Thorell, Nicholas Borg, Frank M Mezzacappa, Carlos M Alvarez, Daniel L Surdell, Mithun G Sattur
{"title":"Endovascular occlusion of external carotid artery: internal jugular vein fistula via direct transcranial access to transverse-sigmoid sinus.","authors":"Kautilya R Patel, William E Thorell, Nicholas Borg, Frank M Mezzacappa, Carlos M Alvarez, Daniel L Surdell, Mithun G Sattur","doi":"10.3171/2025.7.FOCVID2537","DOIUrl":"10.3171/2025.7.FOCVID2537","url":null,"abstract":"<p><p>Endovascular transarterial or retrograde transvenous occlusion is the preferred modality for treatment of dural arteriovenous fistulas at most intracranial locations. However, transvenous navigation to the segment of interest might not be possible due to occlusion or stenosis of an extracranial or intracranial major venous channel. Direct transcranial access to a major venous sinus proximal to the occlusion is a useful strategy in such situations. This video demonstrates successful endovascular coil embolization of an external carotid artery-internal jugular vein fistula below the jugular foramen through direct transcranial access to the transverse-sigmoid sinus in a patient with bilateral internal jugular vein occlusion. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2537.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"13 2","pages":"V15"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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