PubMed · 5467998
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S Waga, H Kikuchi, Y Kamijo, J Handa, H Handa. 1970. [Cavernous sinus venography].. https://pubmed.ncbi.nlm.nih.gov/5467998/
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BACKGROUND: Most cavernous sinus dural arteriovenous malformations (CSdAVM) have a benign clinical course. Those CSdAVM that drain into cortical veins have an increased risk for neurologic complications. OBJECTIVE: To find whether a specific clinical sign predicts cortical venous drainage (CVD) in CSdAVM. METHODS: The records of 118 patients with CSdAVM were evaluated for the clinical features of the disorder and tested for predictive value of CVD demonstrated angiographically or suggested by MRI using logistic regression and odds ratio (OR) analysis. RESULTS: Clinical signs that predicted the presence of CVD included bilateral orbital signs (p = 0.004, OR = 23.84) and presence of a postauricular bruit (p = 0.035, OR = 23.8). No other clinical sign predicted the presence of CVD, including extraocular muscle dysfunction, abducens or oculomotor dysfunction, increased intraocular pressure, venous stasis retinopathy, choroidal effusion, optic neuropathy, subjective bruit, and objective orbital bruit. CONCLUSION: Patients who present with or develop bilateral orbital congestion should be recognized as being at increased risk for CVD.
Two patients with vascular lesions of the cavernous sinus (CS) undergoing endovascular management are reported. During transvenous embolization an unusually low termination of the inferior petrosal sinus (IPS) was observed. In both patients, we were able to catheterize the CS using this aberrant venous route. Knowledge of this variant can be crucial for a successful transvenous approach and treatment of vascular lesions involving the cavernous sinus.
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