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Cerebrospinal Fluid-Venous Fistulas
Cerebrospinal fluid-venous fistulas (CSFVFs) were first described in 2014 and have since become an increasingly diagnosed cause of spontaneous intracranial hypotension due to increased clinical recognition and advancements in diagnostic modalities. In this review, the authors discuss CSFVF epidemiology, the variety of clinical presentations, the authors ’ preferred diagnostic approach, recent advancements in diagnostic methods, treatment options, current challenges, and directions of future research. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - April 12, 2024 Category: Neurosurgery Authors: Nitesh P. Patel, Waleed Brinjikji Source Type: research

Vein of Galen Malformations
Significant efforts have been made over the last few decades to improve the diagnosis and management of patients with vein of Galen malformations (VOGMs). The mainstays of treatment remain focused on primary endovascular management by staged transarterial embolizations with adjunctive use of transvenous embolization, medical therapy, and neurosurgical intervention for symptom control in select patients. Innovation in endovascular technology and techniques as well as promising new genomic research elucidating potential therapeutic targets hold significant promise for the future of VOGM treatment. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - April 9, 2024 Category: Neurosurgery Authors: Alex Devarajan, Daryl Goldman, Tomoyoshi Shigematsu, Alejandro Berenstein, Johanna T. Fifi Source Type: research

Venous Sinus Stent to Treat Paralysis
Transvenous treatment of paralysis is a concept less than a decade old. The Stentrode (Synchron, Inc, New York, USA) is a novel electrode on stent device intended to be implanted in the superior sagittal sinus adjacent to the motor cortex. Initial animal studies in sheep demonstrated the safety of the implant as well as its accuracy in detecting neural signals at both short and long term. Early human trials have shown the safety of the device and demonstrated the use of the Stentrode system in facilitating patients with paralysis to carry out daily activities such as texting, email, and personal finance. This is an emergin...
Source: Neurosurgery Clinics of North America - April 8, 2024 Category: Neurosurgery Authors: Kurt Yaeger, J. Mocco Source Type: research

Venous Anatomy of the Central Nervous System
Comprehensive understanding of venous anatomy is a key factor in the approach to a multitude of conditions. Moreover, the venous system has become the center of attention as a new frontier for treatment of diseases such as idiopathic intracranial hypertension (IIH), arteriovenous malformation (AVM), pulsatile tinnitus, hydrocephalus, and cerebrospinal fluid (CSF) venous fistulas. Its knowledge is ever more an essential requirement of the modern brain physician. In this article, the authors explore the descriptive and functional anatomy of the venous system of the CNS in 5 subsections: embryology, dural sinuses, cortical ve...
Source: Neurosurgery Clinics of North America - April 6, 2024 Category: Neurosurgery Authors: Maksim Shapiro, Charlotte Chung, Vera Sharashidze, Erez Nossek, Peter Kim Nelson, Eytan Raz Source Type: research

Causes of Pulsatile Tinnitus and Treatment Options
Pulsatile tinnitus (PT) requires detailed workup to evaluate for an underlying structural cause. With advances in neuroimaging, structural venous abnormalities that can cause PT have becoming increasingly recognized. A number of anomalies, including dural arteriovenous fistulas, idiopathic intracranial hypertension, transverse sinus stenosis, sigmoid sinus wall abnormalities, jugular venous anomalies, and hypertrophied emissary veins, have been implicated in flow disruption and turbulence in the vicinity of auditory structures, resulting in PT. Endovascular treatment options, including stenting, coiling, and embolization w...
Source: Neurosurgery Clinics of North America - April 6, 2024 Category: Neurosurgery Authors: Badih J. Daou, Andrew F. Ducruet Source Type: research

Cavernous Sinus Thrombosis
Cavernous sinus thrombosis is a potentially lethal subset of cerebral venous sinus thrombosis that may occur as a result of septic and aseptic etiologies. The overall incidence is estimated to be between 0.2 and 1.6 per 100,000 persons; and treatments include antibiotics, anticoagulation, corticosteroids, and surgery. Recent morbidity and mortality estimates are approximately 15% and 11%, respectively. Rapid identification and treatment are essential and may reduce the risk of poor outcome or death. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - April 4, 2024 Category: Neurosurgery Authors: Steven B. Housley, Matthew J. McPheeters, Kunal P. Raygor, Mehdi Bouslama, Tyler Scullen, Jason M. Davies Source Type: research

Idiopathic Intracranial Hypertension
Idiopathic intracranial hypertension is defined by headaches and a decline in visual acuity due to increased intracranial pressure. Treatment options historically included weight loss, acetazolamide, and/or cerebrospinal fluid diversion surgery. Recent understanding of the contributions of dural venous sinus hypertension and stenosis has led to venous sinus stenting as a treatment option. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 21, 2024 Category: Neurosurgery Authors: Matthew Anderson, Eliza Baird-Daniel, Raymond Michael Meyer, Michael R. Levitt Source Type: research

Carotid Cavernous Fistula
Carotid cavernous fistulae (CCFs) are arteriovenous shunts involving the cavernous sinus. CCFs are defined as direct or indirect. Direct CCFs are treated by deconstructive or reconstructive techniques depending on whether the affected internal carotid artery is required to perfuse the ipsilateral cerebral hemisphere, as determined by a balloon test occlusion. Indirect CCFs, or dural fistulae of the cavernous sinus wall, are most often treated with transvenous embolization. Stereotactic radiosurgery is reserved for cases of indirect CCFs that are not completely obliterated by embolization. Overall, cure rates are high with ...
Source: Neurosurgery Clinics of North America - March 21, 2024 Category: Neurosurgery Authors: Brian M. Howard, Daniel L. Barrow Source Type: research

Dural Arteriovenous Fistula
Dural arteriovenous fistulas are rare cerebrovascular lesions arising from abnormal connections between an artery and a vein. Though rare, high-grade aggressive lesions can cause hemorrhagic events and non-hemorrhagic neurologic deficits if left untreated. Treatment options vary based on angioarchitecture, location, and patient characteristics and range from conservative observation to palliative treatment, radiosurgery, endovascular embolization, and open surgery. The main goal of treatment is to obliterate flow through the abnormal connection and prevent further arterial flow to the venous system. (Source: Neurosurgery C...
Source: Neurosurgery Clinics of North America - March 21, 2024 Category: Neurosurgery Authors: Kareem El Naamani, Stavropoula I. Tjoumakaris, Michael Reid Gooch, Pascal Jabbour Source Type: research

Cerebral Venous Sinus Thrombosis
Cerebral venous sinus thrombosis (CVST) is a rare type of stroke indicated by the formation of blood clots within the dural venous sinuses. These are large venous conduits that are situated between the 2 layers of the dura mater which are responsible for draining blood from the brain and returning it to the systemic circulation. Cortical venous thrombosis refers to the blockage of veins on the brain ’s cortical surface. Cerebral venous thrombosis encompasses both dural and cortical vein occlusions. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 21, 2024 Category: Neurosurgery Authors: Vincent N. Nguyen, Alexandra N. Demetriou, Jonathan Dallas, William J. Mack Source Type: research

Developmental Venous Anomalies
Developmental venous anomalies (DVAs) are the most common vascular malformation detected on intracranial cross-sectional imaging. They are generally benign lesions thought to drain normal parenchyma. Spontaneous hemorrhages attributed to DVAs are rare and should be ascribed to associated cerebral cavernous malformations, flow-related shunts, or venous outflow obstruction. Contrast-enhanced MRI, susceptibility-weighted imaging, and high-field MRI are ideal tools for visualizing vessel connectivity and associated lesions. DVAs are not generally considered targets for treatment. Preservation of DVAs is an established practice...
Source: Neurosurgery Clinics of North America - March 21, 2024 Category: Neurosurgery Authors: Li Ma, Samer S. Hoz, Jonathan A. Grossberg, Michael J. Lang, Bradley A. Gross Source Type: research

New Technologies In Spine Surgery
NEUROSURGERY CLINICS OF NORTH AMERICA (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - February 28, 2024 Category: Neurosurgery Authors: Adam S. Kanter, Nicholas Theodore Source Type: research

Copyright
ELSEVIER (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - February 28, 2024 Category: Neurosurgery Source Type: research

Contributors
RUSSELL R. LONSER, MD (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - February 28, 2024 Category: Neurosurgery Source Type: research

Contents
Adam S. Kanter and Nicholas Theodore (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - February 28, 2024 Category: Neurosurgery Source Type: research