Orbital arteriovenous malformation mimicking cavernous sinus dural arteriovenous malformation. 2000

R Huna-Baron, and A Setton, and M J Kupersmith, and A Berenstein
Sheba Medical Center, Tel Aviv, Israel.

OBJECTIVE Orbital arteriovenous malformations (OAVM) are rare, mostly described with high flow characteristics. Two cases are reported with an OAVM of distinct haemodynamic abnormality. The clinical, angiographic features, and the management considerations are discussed. METHODS Case review of two patients with dural AVM (DAVM) who presented to referral neuro-ophthalmology and endovascular services because of clinical symptoms and signs consistent with a cavernous sinus dural AVM. RESULTS In each patient, superselective angiography revealed a small slow flow intraorbital shunt supplied by the ophthalmic artery. The transarterial and transvenous endovascular approaches to treat the malformation were partially successful. Although, the abnormal flow was reduced, complete closure of the DAVM could not be accomplished without significant risk of iatrogenic injury. Neither patient's vision improved after intervention. CONCLUSIONS A DAVM in the orbit can cause similar clinical symptoms and signs to those associated with a cavernous sinus DAVM. Even with high resolution magnetic resonance imaging, only superselective angiography can identify this small intraorbital slow flow shunt. The location in the orbital apex and the small size precludes a surgical option for treatment. The transarterial and transvenous embolisation options are limited.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D009880 Ophthalmic Artery Artery originating from the internal carotid artery and distributing to the eye, orbit and adjacent facial structures. Arteries, Ophthalmic,Artery, Ophthalmic,Ophthalmic Arteries
D011681 Pupil Disorders Conditions which affect the structure or function of the pupil of the eye, including disorders of innervation to the pupillary constrictor or dilator muscles, and disorders of pupillary reflexes. Afferent Pupillary Defect,Efferent Pupillary Defect,Marcus-Gunn Pupil,Pupil Reaction Absent,Pupillary Functions, Abnormal,Deformed Pupil,Ectopic Pupil,Fixed Pupils,Keyhole Pupil,Non-Syphilitic Argyll-Robertson Pupil,Occluded Pupils,Pupil Malformations,Pupillary Anomaly,Pupillary Disorders,Pupillary Occlusion,Pupillary Paralysis,Pupillary Sector Paralysis,Pupillary Sphincter Rupture,Sector Pupil Palsy,Wernicke Hemianopic Pupil,Wernicke's Hemianopic Pupil,Abnormal Pupillary Function,Abnormal Pupillary Functions,Afferent Pupillary Defects,Anomalies, Pupillary,Anomaly, Pupillary,Argyll-Robertson Pupil, Non-Syphilitic,Deformed Pupils,Ectopic Pupils,Efferent Pupillary Defects,Fixed Pupil,Hemianopic Pupil, Wernicke,Hemianopic Pupil, Wernicke's,Keyhole Pupils,Malformation, Pupil,Malformations, Pupil,Marcus Gunn Pupil,Non Syphilitic Argyll Robertson Pupil,Occluded Pupil,Occlusion, Pupillary,Occlusions, Pupillary,Paralyses, Pupillary,Paralyses, Pupillary Sector,Paralysis, Pupillary,Paralysis, Pupillary Sector,Pupil Disorder,Pupil Malformation,Pupil, Deformed,Pupil, Ectopic,Pupil, Fixed,Pupil, Keyhole,Pupil, Marcus-Gunn,Pupil, Non-Syphilitic Argyll-Robertson,Pupil, Occluded,Pupil, Wernicke Hemianopic,Pupil, Wernicke's Hemianopic,Pupillary Anomalies,Pupillary Defect, Afferent,Pupillary Defect, Efferent,Pupillary Defects, Afferent,Pupillary Defects, Efferent,Pupillary Disorder,Pupillary Function, Abnormal,Pupillary Occlusions,Pupillary Paralyses,Pupillary Sector Paralyses,Pupillary Sphincter Ruptures,Pupils, Deformed,Pupils, Ectopic,Pupils, Fixed,Pupils, Keyhole,Pupils, Occluded,Reaction Absent, Pupil,Reaction Absents, Pupil,Rupture, Pupillary Sphincter,Ruptures, Pupillary Sphincter,Sector Paralyses, Pupillary,Sector Paralysis, Pupillary,Sphincter Rupture, Pupillary,Sphincter Ruptures, Pupillary,Wernickes Hemianopic Pupil
D002426 Cavernous Sinus An irregularly shaped venous space in the dura mater at either side of the sphenoid bone. Sinus, Cavernous
D002538 Intracranial Arteriovenous Malformations Congenital vascular anomalies in the brain characterized by direct communication between an artery and a vein without passing through the CAPILLARIES. The locations and size of the shunts determine the symptoms including HEADACHES; SEIZURES; STROKE; INTRACRANIAL HEMORRHAGES; mass effect; and vascular steal effect. Arteriovenous Malformations, Cerebral,Intracranial Arteriovenous Malformations, Congenital,AVM (Arteriovenous Malformation) Intracranial,Cerebral Arteriovenous Malformations,Congenital Intracranial Arteriovenous Malformations,Intracranial Arteriovenous Malformation, Ruptured,Ruptured Intracranial Arteriovenous Malformation,Arteriovenous Malformation, Cerebral,Arteriovenous Malformation, Intracranial,Arteriovenous Malformations, Intracranial,Cerebral Arteriovenous Malformation,Intracranial Arteriovenous Malformation,Malformation, Cerebral Arteriovenous,Malformation, Intracranial Arteriovenous,Malformations, Cerebral Arteriovenous,Malformations, Intracranial Arteriovenous
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004621 Embolization, Therapeutic A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage. Embolotherapy,Therapeutic Embolization,Embolizations, Therapeutic,Embolotherapies,Therapeutic Embolizations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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