Vascular (AG)

Question 1

What is classification of (cranial) dural AVF and haemorrhage rates?

Answer 1

Borden classification

Grade I - flow in to dural venous sinuses only - 0% haemorrhage rate
Grade II -flow in to dural venous sinuses AND retrograde flow in to leptomeningeal vessels - 11% haemorrhage rate
Grade III - flow in to leptomeningeal vessels only - 48% haemorrhage rate

Question 2

How do vein of Galen malformations present?

Answer 2

Neonates: congestive heart failure
Infants: macrocrania, hydrocephalus, facial venous collateralisation/congestion, epistaxis
>1-2 years - developmental delay, Intracranial haemorrhage, seizures.

Question 3

ISAT outcomes?

Answer 3

Clipping - dead/dependent at 1 year 30%

Coiling - dead/dependent at 1 year 23.7%

Question 4

Define foetal PCommA/foetal PCA?

Answer 4

Diameter of P1 < PComm (i.e. P2 is supplied via PComm rather than P1)

Question 5

Boundaries of pineal region?

Answer 5

Anterior - III ventricle - pineal recess
Anterosuperior - habenular
Superiorly - internal cerebral veins/Galen, splenium of corpus callosum
Posteroinferior - superior cerebellar cistern
Inferior - superior coliculi
Antero-inferior - posterior commisure