1997 Fiscal Year Final Research Report Summary
Etiological evaluation of dural arteriovenous malformations of the transverse-sigmoid sinuses based on histopathological examination.
| Project/Area Number |
07457309
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | TOYAMA MEDICAL AND PHARMACEUTICAL UNIVERSITY |
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Principal Investigator |
KUWAYAMA Naoya Toyama Medical and Pharmaceutical University, Department of Neurosurgery, Assistant Professer, 附属病院, 講師 (30178157)
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| Project Period (FY) |
1995 – 1997
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| Keywords | duial arteriovenous malformation / arteriovenous fistula / dural sinus thrombosis |
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| Research Abstract |
In order to elucidate the pathogenesis of dural arteriovenous malformations (AVM's) of the transverse-sigmoid sinuses, histopathological profiles of this disease were studied in serial sections of completely resected lesions from three patients. The intima of the sinuses was thickened ; interruption and thickening were noted in the elastic laminae. The dural arteries ware markedly twisted and elongated, and showed remarkable fibrous thickening in the intima and adventitia. Veins were markedly dilated and had communication with one another and with the lumens of the venous sinuse. Fistulas were seen not between dural arteries and venous sinuses., but between aetreries with a diameter of about 200 micron and dilated dural veins.The anatomical structure of these fistulas between dural arteries and dural veins was clearly demonstrated in a 3-D reconstruction image by a computer. The essential lesion of this disease was confirmed to be a dural arteriovenous fistula within the wall of of the venous sinuses. We believe that this result could explain the mechanisms of recurrence after transvenous embolization of the involved sinuses, i.e., transvenous embolization occludes the site of draining routes, not the fistulas themselves. These fistulas will be obliterated in most of the lesions, but may find other draining routes through the well-developed venous netwook system around the involved sinuses.
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