{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:20:46Z","timestamp":1761844846275,"version":"3.37.3"},"reference-count":27,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2018,2,2]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Engorged medullary vein (EMV) in patients with intracranial dural arteriovenous fistula (DAVF) suggests venous congestion. The aim of this study is to investigate its prevalence, pattern, and correlation with clinical findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>CT angiography (CTA) raw data of DAVF were used for multiplanar reconstruction and then analyzed for the presence and pattern of EMV, which is defined as a dilated vein in the cerebral white matter. Patients with EMV were divided into two groups: regional and extensive. Regional type is defined as EMV limited to one cerebral hemisphere or cerebellum without evidence of subcortical calcification. Extensive type is defined as EMV involvement of more than one cerebral hemisphere or both the cerebrum and cerebellum. Descriptive analysis of clinical information, DAVF characteristics, and other imaging findings was conducted. Clinical information, including demographic data, clinical presentation, and hemorrhage, were correlated with both types of EMV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 192 eligible patients with DAVF, 71 (37%) had EMV. Patients with EMV were older (63 years vs 56 years, P=0.02), with DAVF more often at the transverse and sigmoid sinus (P&lt;0.001), and more often presented with aggressive symptoms (59% vs 34%, P=0.02) than non-EMV patients, but there was no difference in the presentation of hemorrhage (15% vs 16%, P=0.99). Patients with regional EMV had a higher proportion of hemorrhage than those with the extensive type (24% vs 0%, P=0.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EMV in patients with DAVF is associated with an aggressive manifestation. Regional type EMV is associated with a higher risk of a hemorrhagic presentation.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2017-013660","type":"journal-article","created":{"date-parts":[[2018,2,20]],"date-time":"2018-02-20T01:40:31Z","timestamp":1519090831000},"page":"1114-1119","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Engorged medullary vein on CT angiography in patients with dural arteriovenous fistula: prevalence, types, and comparison between regional and extensive types"],"prefix":"10.1136","volume":"10","author":[{"given":"Yen-Heng","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Wei","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Fen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Ju","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-Fang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6715-6366","authenticated-orcid":false,"given":"Hon-Man","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,19]]},"reference":[{"key":"2024052304022529000_10.11.1114.1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2798"},{"key":"2024052304022529000_10.11.1114.2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.008228"},{"key":"2024052304022529000_10.11.1114.3","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.194.3.7862961"},{"key":"2024052304022529000_10.11.1114.4","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.82.2.0166"},{"key":"2024052304022529000_10.11.1114.5","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1177\/159101990200800306","article-title":"MR detection of dilated deep medullary veins in intracranial dural arteriovenous fistulas with retrograde leptomeningeal venous drainage","volume":"8","author":"Chan","year":"2002","journal-title":"Interv Neuroradiol"},{"key":"2024052304022529000_10.11.1114.6","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1986.64.5.0724"},{"key":"2024052304022529000_10.11.1114.7","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.8.1538"},{"key":"2024052304022529000_10.11.1114.8","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.10091835"},{"key":"2024052304022529000_10.11.1114.9","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000338066.30665.B2"},{"key":"2024052304022529000_10.11.1114.10","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1990.72.6.0839"},{"key":"2024052304022529000_10.11.1114.11","first-page":"1031","article-title":"Tortuous, engorged pial veins in intracranial dural arteriovenous fistulas: correlations with presentation, location, and MR findings in 122 patients","volume":"20","author":"Willinsky","year":"1999","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052304022529000_10.11.1114.12","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1212\/WNL.0000000000000448","article-title":"Association of pial venous reflux with hemorrhage or edema in dural arteriovenous fistula","volume":"82","author":"Zhao","year":"2014","journal-title":"Neurology"},{"key":"2024052304022529000_10.11.1114.13","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.516757"},{"key":"2024052304022529000_10.11.1114.14","first-page":"739","article-title":"Vein of the white matter of the cerebral hemisphere (the medullary veins)","volume":"92","author":"Huang","year":"1964","journal-title":"Am J Roentgenol Radium Ther Nucl Med"},{"key":"2024052304022529000_10.11.1114.15","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1789.1999.00215.x"},{"key":"2024052304022529000_10.11.1114.16","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e318230966f"},{"key":"2024052304022529000_10.11.1114.17","first-page":"651","article-title":"Dural arteriovenous fistulas with cortical venous drainage: incidence, clinical presentation, and treatment","volume":"28","author":"van Rooij","year":"2007","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052304022529000_10.11.1114.18","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000014772.02908.44"},{"key":"2024052304022529000_10.11.1114.19","doi-asserted-by":"publisher","DOI":"10.1054\/jocn.2001.1029"},{"key":"2024052304022529000_10.11.1114.20","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12337"},{"key":"2024052304022529000_10.11.1114.21","doi-asserted-by":"crossref","unstructured":"Fujita K , Kojima N , Tamaki N , et al . Brain edema in intracranial venous hypertension. In: Inaba Y , Klatzo I , Spatz M , eds. Brain Edema: Proceedings of the Sixth International Symposium, 7\u201310 November\u00a01984, Tokyo . 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