Dural arteriovenous fistula (DAVF): Difference between revisions
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==Cognard Classification== | ==Cognard Classification== | ||
[[File:Cognard Classification.png|thumb]] | [[File:Cognard Classification.png|thumb]] | ||
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!Venous drainage | !Venous drainage | ||
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|Progressive myelopathy in 50% | |Progressive myelopathy in 50% | ||
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<blockquote>Presence of cortical venous drainage is the most important determinant of rupture nsk from dural arteriovenous fistula. | |||
The other factors listed have not been convincingly linked to risk of hemorrhage.</blockquote> | |||
[[Category:Vascular Pathology]] | [[Category:Vascular Pathology]] | ||
Revision as of 01:07, 16 September 2023
DAVF Classification
The two most common classifications for dural AVFs are the Borden and the Cognard classification shown below:
Borden Classification
| Type | Features |
|---|---|
| I | DAVF drainage into a dural venous sinus or meningeal veins, with normal anterograde flow.
Usually clinically benign. |
| II | DAVF draining anterograde into dural venous sinus, but with retrograde flow into cortical veins. |
| III | DAVF with direct retrograde flow from fistula into cortical veins, causing venous hypertension. |
Cognard Classification
| Venous drainage | Type | Features | Course |
|---|---|---|---|
| Sinus | I | Normal antegrade flow into a dural venous sinus | Benign course |
| IIa | Drainage into a sinus with retrograde flow within the sinus | Sinus reflux caused IC-HTN in 20% | |
| IIb | Drainage into a sinus with retrograde flow into cortical vein(s) | Reflux into veins induced hemorrhage in 10% | |
| IIa + b | Drainage into a sinus with retrograde flow within the sinus and cortical vein(s) | Aggressive in 66% with bleeding and/or IC-HTN | |
| Cortical veins | III | Direct drainage into a cortical vein without venous ectasia | Hemorrhage occurs in 40% |
| IV | Direct drainage into a cortical vein with venous ectasia | Hemorrhage occurs in 65% | |
| Spinal | V | Direct drainage into spinal perimedullary veins in addition to all of the above | Progressive myelopathy in 50% |
Presence of cortical venous drainage is the most important determinant of rupture nsk from dural arteriovenous fistula. The other factors listed have not been convincingly linked to risk of hemorrhage.