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Author: admin | 01.12.2014 | Category: Ringing In The Ears Causes

When a fistula forms, blood from an artery under high pressure and flow goes directly into a vein, which is a low pressure and low flow structure.  Even though the fistula is not directly on or within the brain, it can nevertheless lead to brain dysfunction by congesting the brain venous system, as will be explained below. Finally, many patients who have dural fistulas of all sizes and locations can have a myriad of symptoms such as different kinds of headache, tiredness, loss of concentration, memory problems, even hallucinations, psychosis or other psychiatric problems.  Unfortunately, in these patients the diagnosis of dural fistula can be significantly delayed because dural fistulas are relatively rare, while the above symptoms are very common and usually not due to a fistula. For an in-depth presentation on treatment of Brain Dural AV Fistulas, primarily geared towards neurointerventional professionals, you can visit Techniques: Brain Dural AV Fistula Embolization page.
Below are pictorial diagrams of what a fistula is like and how it can be treated.  The actual anatomy is much more complicated, but the pictures provide a frame of reference.
Finally, post-embolization views, showing the coils in the cavernous sinus (white arrows) and no evidence of fistula on injections of the external carotid artery (brown arrows).  This approach, though technically challenging, can be quite successful when other venues prove unfeasible. This patient developed a fistula on the dural covering that separates the back part of the brain, called cerebellum, from the overlying occipital lobe. MRA images (top) and stereo MRA composite (MIP) images on the bottom, demonstrating multiple intracranial and extracranial vessels (red arrows) feeding the fistula. The microcatheter has been positioned into another branch of the middle meningeal artery, showing residual fistula and aneurysm.  More glue is injected from this position. Post-embolization views of the left common carotid artery, showing that the fistula is gone.


Our group at the NYU Langone Medical Center is one of the premier neurointerventional centers in the world. When a fistula forms between an artery and a vein within the dura, it is called Brain Dural Fistula, or Brain Dural Arteriovenous Fistula, or BDAVF, etc. The total amount of radiation delivered to the patient at conclusion of a dynamic CT scan, however, can be VERY high — in some cases resulting in (usually temporary) hair loss. The bottom picture is venogram obtained by directly injecting the cavernous sinus to demonstrate the basal vein (dark blue) and ophthalmic vein (light blue arrows).  Some coils have already been placed into the sinus. External and middle ear diseases: Radiological diagnosis based on clinical signs and symptoms. Computed tomography and magnetic resonance imaging of pathologic conditions of the middle ear. The details of any treatment are best discussed with the specialist performing the procedure.
Temporal bone imaging is challenging and involves deep understanding of the anatomy, especially in relation to High Resolution Computed Tomography (HRCT) imaging.
Cross-sectional imaging has evolved rapidly and has surpassed the radiography and plain film tomography.


Middle ear disease can present as ear pain, otorrohea, hearing impairment and other symptoms. In certain cases, routine and contrast-enhanced Magnetic Resonance Imaging (MRI) scores over HRCT in the evaluation of middle ear soft tissue; however, in most instances, it acts as a next step for confirmation and further characterization. Features are consistent with cholesteatomaClick here to viewFigure 4 (A, B): Coronal image of the left temporal bone shows soft tissue opacification in the middle ear, sclerosis of mastoid, non-visualization of the ossicles, erosion of the facial nerve canal, tegmen (white arrows in A and B), lateral mastoid wall, and extension into the inner ear (black arrow).
The imaging appearance of facial nerve schwannoma has been described as an enhancing tubular mass (using T1-enhanced MR) within an enlarged facial nerve canal (using CT). The aberrant carotid artery may be dehiscent or may be covered by cortical bone so that the otoscopic examination can sometimes be normal.
A jugular bulb is considered "high riding" if it extends above the level of the floor of the internal auditory canal (IAC). It is always important to make a note about the extent of the disease, anatomical variants, and possible complications.



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