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<meta name="DC.Title" content="Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4960" />
<meta name="DC.Date" content="2017-01-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2017 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas.

MATERIALS AND METHODS: Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage. Sinus stenosis and the double peak sign (occurrence of 2 peaks in the time-density curve of the ipsilateral drainage of the internal jugular vein) in dural arteriovenous fistula were evaluated. “TTP” was defined as the time at which a selected angiographic point reached maximum concentration. TTP of the vein of Labbé, TTP of the ipsilateral normal transverse sinus, trans-fistula time, and trans-stenotic time were compared across the 3 groups.

RESULTS: Thirty-six percent of type I, 100% of type IIa, and 84% of types with cortical venous drainage had sinus stenosis. All sinus stenosis cases demonstrated loss of the double peak sign that occurs in dural arteriovenous fistula. Trans-fistula time (2.09 seconds) and trans-stenotic time (0.67 seconds) in types with cortical venous drainage were the most prolonged, followed by those in type IIa and type I. TTP of the vein of Labbé was significantly shorter in types with cortical venous drainage. Six patients with types with cortical venous drainage underwent venoplasty and stent placement, and 4 were downgraded to type IIa.

CONCLUSIONS: Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases.

CVD
:   cortical venous drainage
DAVF
:   dural arteriovenous fistula
SRS
:   stereotactic radiosurgery
SS
:   sinus stenosis
TFT
:   trans-fistula time
TST
:   trans-stenotic time
TTPPV
:   TTP for the parietal vein
TTPVL
:   TTP of the vein of Labbé" />
<meta name="DC.Contributor" content="W.-Y. Guo" />
<meta name="DC.Contributor" content="C.-C.J. Lee" />
<meta name="DC.Contributor" content="C.-J. Lin" />
<meta name="DC.Contributor" content="H.-C. Yang" />
<meta name="DC.Contributor" content="H.-M. Wu" />
<meta name="DC.Contributor" content="C.-C. Wu" />
<meta name="DC.Contributor" content="W.-Y. Chung" />
<meta name="DC.Contributor" content="K.-D. Liu" />
<meta name="article:published_time" content="2017-01-01" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage. Sinus stenosis and the double peak sign (occurrence of 2 peaks in the time-density curve of the ipsilateral drainage of the internal jugular vein) in dural arteriovenous fistula were evaluated. “TTP” was defined as the time at which a selected angiographic point reached maximum concentration. TTP of the vein of Labbé, TTP of the ipsilateral normal transverse sinus, trans-fistula time, and trans-stenotic time were compared across the 3 groups.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Thirty-six percent of type I, 100% of type IIa, and 84% of types with cortical venous drainage had sinus stenosis. All sinus stenosis cases demonstrated loss of the double peak sign that occurs in dural arteriovenous fistula. Trans-fistula time (2.09 seconds) and trans-stenotic time (0.67 seconds) in types with cortical venous drainage were the most prolonged, followed by those in type IIa and type I. TTP of the vein of Labbé was significantly shorter in types with cortical venous drainage. Six patients with types with cortical venous drainage underwent venoplasty and stent placement, and 4 were downgraded to type IIa.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_mjid" content="ajnr;38/1/132" />
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<meta name="citation_firstpage" content="132" />
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<meta name="citation_author" content="W.-Y. Guo" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology (W.-Y.G., C.-J.L., H.-M.W., C.-C.W.)" />
<meta name="citation_author_institution" content="cSchool of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan." />
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<meta name="citation_author" content="C.-C.J. Lee" />
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<meta name="citation_author_institution" content="cSchool of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan." />
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<meta name="citation_author_institution" content="aFrom the Department of Radiology (W.-Y.G., C.-J.L., H.-M.W., C.-C.W.)" />
<meta name="citation_author_institution" content="cSchool of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan." />
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<meta name="citation_author_institution" content="bDepartment of Neurosurgery (C.-C.J.L., H.-C.Y., W.-Y.C., K.-D.L.), Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan" />
<meta name="citation_author_institution" content="cSchool of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-9343-6289" />
<meta name="citation_author" content="K.-D. Liu" />
<meta name="citation_author_institution" content="bDepartment of Neurosurgery (C.-C.J.L., H.-C.Y., W.-Y.C., K.-D.L.), Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan" />
<meta name="citation_author_institution" content="cSchool of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan." />
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<meta name="twitter:title" content="Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas.

MATERIALS AND METHODS: Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage. Sinus stenosis and the double peak sign (occurrence of 2 peaks in the time-density curve of the ipsilateral drainage of the internal jugular vein) in dural arteriovenous fistula were evaluated. “TTP” was defined as the time at which a selected angiographic point reached maximum concentration. TTP of the vein of Labbé, TTP of the ipsilateral normal transverse sinus, trans-fistula time, and trans-stenotic time were compared across the 3 groups.

RESULTS: Thirty-six percent of type I, 100% of type IIa, and 84% of types with cortical venous drainage had sinus stenosis. All sinus stenosis cases demonstrated loss of the double peak sign that occurs in dural arteriovenous fistula. Trans-fistula time (2.09 seconds) and trans-stenotic time (0.67 seconds) in types with cortical venous drainage were the most prolonged, followed by those in type IIa and type I. TTP of the vein of Labbé was significantly shorter in types with cortical venous drainage. Six patients with types with cortical venous drainage underwent venoplasty and stent placement, and 4 were downgraded to type IIa.

CONCLUSIONS: Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases.

CVD
:   cortical venous drainage
DAVF
:   dural arteriovenous fistula
SRS
:   stereotactic radiosurgery
SS
:   sinus stenosis
TFT
:   trans-fistula time
TST
:   trans-stenotic time
TTPPV
:   TTP for the parietal vein
TTPVL
:   TTP of the vein of Labbé" />
<meta name="og-title" property="og:title" content="Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/38/1/132" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Sinus stenosis occasionally occurs in dural arteriovenous fistulas. Sinus stenosis impedes venous outflow and aggravates intracranial hypertension by reversing cortical venous drainage. This study aimed to analyze the likelihood of sinus stenosis and its impact on cerebral hemodynamics of various types of dural arteriovenous fistulas.

MATERIALS AND METHODS: Forty-three cases of dural arteriovenous fistula in the transverse-sigmoid sinus were reviewed and divided into 3 groups: Cognard type I, type IIa, and types with cortical venous drainage. Sinus stenosis and the double peak sign (occurrence of 2 peaks in the time-density curve of the ipsilateral drainage of the internal jugular vein) in dural arteriovenous fistula were evaluated. “TTP” was defined as the time at which a selected angiographic point reached maximum concentration. TTP of the vein of Labbé, TTP of the ipsilateral normal transverse sinus, trans-fistula time, and trans-stenotic time were compared across the 3 groups.

RESULTS: Thirty-six percent of type I, 100% of type IIa, and 84% of types with cortical venous drainage had sinus stenosis. All sinus stenosis cases demonstrated loss of the double peak sign that occurs in dural arteriovenous fistula. Trans-fistula time (2.09 seconds) and trans-stenotic time (0.67 seconds) in types with cortical venous drainage were the most prolonged, followed by those in type IIa and type I. TTP of the vein of Labbé was significantly shorter in types with cortical venous drainage. Six patients with types with cortical venous drainage underwent venoplasty and stent placement, and 4 were downgraded to type IIa.

CONCLUSIONS: Sinus stenosis indicated dysfunction of venous drainage and is more often encountered in dural arteriovenous fistula with more aggressive types. Venoplasty ameliorates cortical venous drainage in dural arteriovenous fistulas and serves as a bridge treatment to stereotactic radiosurgery in most cases.

CVD
:   cortical venous drainage
DAVF
:   dural arteriovenous fistula
SRS
:   stereotactic radiosurgery
SS
:   sinus stenosis
TFT
:   trans-fistula time
TST
:   trans-stenotic time
TTPPV
:   TTP for the parietal vein
TTPVL
:   TTP of the vein of Labbé" />
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    <title>Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study | American Journal of Neuroradiology</title>  
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node49--5" data-node-nid="49" id="top-node-49--61648244110" data-pisa="ajnr;38/1/132" data-pisa-master="ajnr;ajnr.A4960" data-apath="/ajnr/38/1/132.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">INTERVENTIONAL</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Quantifying the Cerebral Hemodynamics of Dural Arteriovenous Fistula in Transverse Sigmoid Sinus Complicated by Sinus Stenosis: A Retrospective Cohort Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">W.-Y. Guo</span>, <span class="highwire-citation-author" data-delta="1">C.-C.J. Lee</span>, <span class="highwire-citation-author" data-delta="2">C.-J. Lin</span>, <span class="highwire-citation-author" data-delta="3">H.-C. Yang</span>, <span class="highwire-citation-author" data-delta="4">H.-M. Wu</span>, <span class="highwire-citation-author" data-delta="5">C.-C. Wu</span>, <span class="highwire-citation-author" data-delta="6">W.-Y. Chung</span> and <span class="highwire-citation-author" data-delta="7">K.-D. Liu</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">January 2017,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">132-138; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4960 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-49--61648244110" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">W.-Y. Guo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (W.-Y.G., C.-J.L., H.-M.W., C.-C.W.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>School of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.-Y.%2BGuo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Guo%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AW.-Y.%2BGuo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-2640-8664" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for W.-Y. Guo</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">C.-C.J. Lee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurosurgery (C.-C.J.L., H.-C.Y., W.-Y.C., K.-D.L.), Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan</div><div class='author-affiliation'><span class='nlm-sup'>c</span>School of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.-C.J.%2BLee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lee%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.-C.J.%2BLee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-4691-2913" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.-C.J. Lee</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">C.-J. Lin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (W.-Y.G., C.-J.L., H.-M.W., C.-C.W.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>School of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.-J.%2BLin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lin%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.-J.%2BLin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-2370-6316" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.-J. Lin</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">H.-C. Yang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurosurgery (C.-C.J.L., H.-C.Y., W.-Y.C., K.-D.L.), Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan</div><div class='author-affiliation'><span class='nlm-sup'>c</span>School of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.-C.%2BYang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yang%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.-C.%2BYang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4949-5417" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H.-C. Yang</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">H.-M. Wu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (W.-Y.G., C.-J.L., H.-M.W., C.-C.W.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>School of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.-M.%2BWu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wu%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.-M.%2BWu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-6466-3792" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H.-M. Wu</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">C.-C. Wu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (W.-Y.G., C.-J.L., H.-M.W., C.-C.W.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>School of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.-C.%2BWu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wu%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.-C.%2BWu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0229-2150" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.-C. Wu</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">W.-Y. Chung </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurosurgery (C.-C.J.L., H.-C.Y., W.-Y.C., K.-D.L.), Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan</div><div class='author-affiliation'><span class='nlm-sup'>c</span>School of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.-Y.%2BChung%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chung%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AW.-Y.%2BChung%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9343-6289" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for W.-Y. Chung</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">K.-D. Liu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurosurgery (C.-C.J.L., H.-C.Y., W.-Y.C., K.-D.L.), Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan</div><div class='author-affiliation'><span class='nlm-sup'>c</span>School of Medicine (W.-Y.G., C.-C.J.L., C.-J.L., H.-C.Y., H.-M.W., C.-C.W., W.-Y.C., K.-D.L.), National Yang-Ming University, Taipei, Taiwan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.-D.%2BLiu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Liu%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AK.-D.%2BLiu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-3883-9955" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K.-D. 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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">132-138; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4960 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">W.-Y.</span> <span class="nlm-surname">Guo</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">C.-C.J.</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">C.-J.</span> <span class="nlm-surname">Lin</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">H.-C.</span> <span class="nlm-surname">Yang</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">H.-M.</span> <span class="nlm-surname">Wu</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">C.-C.</span> <span class="nlm-surname">Wu</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">W.-Y.</span> <span class="nlm-surname">Chung</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">K.-D.</span> <span class="nlm-surname">Liu</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">132-138; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4960 </span></div>
  
  
  
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