Unit of Interventional Neuroradiology

science, Italy

Unit of Interventional Neuroradiology

science, Italy
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Signorelli F.,Neurosurgery Unit D | Signorelli F.,University of Catanzaro | Gory B.,Unit of Interventional Neuroradiology | Maduri R.,University of Lausanne | And 5 more authors.
Journal of Neurosurgical Sciences | Year: 2017

Intracranial dural arteriovenous fistulas are a rarely diagnosed type of vascular malformations, yet they are clinically relevant in a subspecialized neurovascular setting because a misdiagnosis may lead to permanent morbidity and mortality. Modern brain imaging techniques such as flat panel detector computed tomographic angiography and magnetic resonance imaging angiography have a significant role in the preoperative work-up, still digital subtraction angiography remains the neuroimaging mainstay. The most important factor guiding their management is the presence of cortical venous reflux, significantly associated with aggressive symptoms due to cerebral or spinal cord venous congestion and hemorrhage. Cutting-edge developments in endovascular and neurosurgical treatment of these vascular malformations, which should be undertaken in specialized referral centers, have substantially improved their prognosis. While transarterial or transvenous endovascular techniques represent frequently the therapy of choice, surgery remains a very valuable option both as a first line treatment and after partial embolization has been carried out. A significant neurosurgical advance is the introduction of indocyanine green video angiography, which allows precise identification of the arterialized draining vein of the dural fistula to be disconnected and confirms interruption of the arteriovenous shunt. Stereotactic radiosurgery may be considered in case of intracranial dural arteriovenous fistulas without cortical venous drainage for which surgical and endovascular options have been consumed or for palliation. © 2015 Edizioni Minerva Medica.


Briganti F.,University of Naples | Tedeschi E.,Neuroradiology Unit | Leone G.,Unit of Interventional Neuroradiology | Marseglia M.,Unit of Interventional Neuroradiology | And 4 more authors.
Neuroradiology Journal | Year: 2013

This report describes endovascular approaches for occlusion of vertebro-vertebral arteriovenous fistula (W-AVF) in a series of three cases and a review of the literature. Complete neuroimaging assessment, including CT, MR and DSA was performed in three patients (two female, one male) with W-AVF. Based on DSA findings, the W-AVF were occluded by endovascular positioning of detachable balloons (case 1), coils (case 2), or a combination of both (case 3) with parent artery patency in two out of three cases. In this small series, endovascular techniques for occlusion of W-AVF were safe and effective methods of treatment. To date, there are no guidelines on the best treatment for W-AVF. Detachable balloons, endovascular coiling, combined embolization procedures could all be considered well-tolerated treatments.


Briganti F.,Unit of Interventional Neuroradiology | Leone G.,Unit of Interventional Neuroradiology | Briganti G.,Unit of Interventional Neuroradiology | Orefice G.,Reproductive and Odontostomatologic science | And 2 more authors.
Neuroradiology Journal | Year: 2013

We describe a 62-year-old woman who presented with a history of ataxia, dizziness and urinary urgency. Neurological examination disclosed a positive Romberg sign, ataxia and postural instability. A magnetic resonance imaging (MRI) scan showed Chiari type 1 malformation (CM1). Forty-eight months later, the patient was clinically improved and underwent a second MRI examination, which showed complete resolution of the Chiari 1 malformation. Spontaneous resolution of CMl is exceptionally rare and has to be considered in the radiological and clinical management.

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