World Neurosurg
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Spinal arteriovenous malformations (AVMs) are rare lesions that may cause serious neurologic morbidity. With developments in endovascular technology and embolic materials, endovascular management of spinal AVMs has gained popularity. ⋯ Spinal AVMs manifesting as intracranial SAH are uncommon. These lesions are frequently overlooked on cerebral angiography and account for a small proportion of angiogram-negative SAHs. A negative angiogram in the setting of SAH should prompt a comprehensive evaluation of the cervical segmental arterial supply to exclude a cervical spinal AVM. Endovascular embolization may be effective in treating spinal glomus AVMs with good clinical outcomes and with complete angiographic obliteration. Onyx embolic agent should be considered as the agent of choice to manage spinal glomus AVMs.
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Although ventriculoperitoneal shunt (VPS) surgery is the most frequent surgical treatment for patients with hydrocephalus, modern rates of complications in adults are uncertain. ⋯ Complications are not infrequent after VPS surgery; however, most complications appear to be clustered in the first year after VPS insertion.
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Dural arteriovenous fistulas (DAVFs) of the sinus of the lesser sphenoid wing (SLSW) with leptomeningeal drainage are rare. We report a patient with a DAVF of the SLSW draining into the basal vein of Rosenthal (BVR) presenting with pontine hemorrhage. ⋯ A DAVF of the SLSW presenting with pontine hemorrhage is extremely rare, and DAVFs with deep leptomeningeal drainage should be included among a variety of etiologies of pontine hemorrhage.