Risk Factors and Clinical Outcome in Hemorrhagic Intracranial Dural Arteriovenous Fistulas After Endovascular Treatment

Purpose The purpose of this study was to analyze the risk factors of hemorrhage in DAVFs and the factors that influence the clinical outcome of hemorrhagic intracranial DAVFs after endovascular treatment. Methods We reviewed the records of patients with hemorrhagic intracranial DAVFs who received endovascular embolization from December 1996 to April 2015. We analyzed the risk factors of hemorrhage and emphasized the drainage pattern and the classification of drainage location. We also analyzed the factors that influence clinical outcomes such as the patient's age and the time interval between hemorrhage and treatment.Results A total of 32 patients were included in this study. Twenty-seven (84.4%) had engorged medullary veins (EMVs), and 24 (75%) of the hemorrhagic DAVFs had dorsal epidural drainage. Twenty-five (78.1%) had complete occlusion on post-procedural angiography. A significant difference (p=0.0054) of the modified Rankin Scale after treatments between the groups who received treatment within or exceeding 14 days after diagnosis. Conclusions Regional EMVs and dorsal epidural drainage patterns are risk factors in the prediction of hemorrhage in intracranial DAVFs. Patients who received early treatment within 14 days after hemorrhage could have a better clinical outcome.