Bilateral orbital signs predict cortical venous drainage in cavernous sinus dural AVMs.

Abstract:

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.

journal_name

Neurology

journal_title

Neurology

authors

Stiebel-Kalish H,Setton A,Berenstein A,Kalish Y,Nimii Y,Kupersmith MJ

doi

10.1212/wnl.58.10.1521

subject

Has Abstract

pub_date

2002-05-28 00:00:00

pages

1521-4

issue

10

eissn

0028-3878

issn

1526-632X

journal_volume

58

pub_type

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