Utilizing your Facebook feed, Twitter feed or Turnblr, pursue a question that in

Question

Utilizing your Facebook feed, Twitter feed or Turnblr, pursue a question that interests you based on the articles posted by your friends. You do not have to use an article from your own feed, but can search through your friends feed for one that sparks your interest. From this initial interest, you will engage in research purposefully and effectively communicate what you learn to a more public audience. You will also be able to learn critically about the credibility of sources, as well as think critically about your stance on any given issue. To start some of my friends on Facebook post articles, and the spectrum of interests and opinions is wide Some examples 1 saw today are Ebola in America Climate change Digital surveillance Medical and legalizing marijuana Militarization of police National election-based Whether to salute as president with coffee in your hand or not Anything cats For example, recently a website titled The national Report published a news article stating that Facebook would begin charging users a monthly fee of $2.99 There were quotes from Facebook founder Mark Zuckerberg. Wall Street analysis. and most importantly, angry students Without researching the reliability of the source, this article popped up on millions of user's feeds and was deemed factual without reservation This essay asks you to examine the article/Issue in depth by a variety of source material to determine its scholarly and primary source material you will analyze your merest in the issue, as well as the lager deeper understanding of the issue thirdly develop a critical argument about the issue that focuses on in-depth analysis

Explanation / Answer

I have recently read an article regarding Dural arteriovenous fistulae on Facebook, I have researched about it on john hopkin's website, and I found it interesting so I read some more scientific journals and prepared an essay on Dural arteriovenous fistulae:

Dural arteriovenous fistulae (DAVF)

Dural arteriovenous fistulae (DAVF) are rare, abnormal connections between arteries and veins in a protective membrane on the outer layer of the brain and spine, called the dura. These abnormal blood vessels divert blood from the normal paths. If the volume of diverted blood flow is large, tissue downstream may not receive an adequate blood and oxygen supply which can lead to aneurysms or ruptures in the veins.

This condition can be caused by head trauma, infection, surgery or thrombosis, or may be a congenital or birth defect.

DAVFs are part of a group of conditions called arteriovenous malformations (AVM). Some fistulas are life-threatening and may cause headaches, seizures or strokes, if they rupture.

Symptoms

Although dural arteriovenous fistulas are located outside the brain, they can cause a wide range of neurological symptoms. Symptoms largely depend on the drainage pattern. The symptoms of dural arteriovenous fistulae (DAVF) can vary widely, depending on the location of the fistulae.

Few common symptoms includes:

·         Headaches: are among the most common symptoms with DAVFs

·         Ringing in Ears: When the DAVF is near the ear, an unusual ringing or humming in the ears may be a symptom, some patients hear a pulsating noise caused by blood flow through the fistula.

·         Stroke-like Symptoms: DAVFs can cause stroke-like symptoms and seizures, if they rupture. Bleeding in the brain is the most serious side effect and can cause permanent disability or death.

·         Visual Problems: Patients often complain of impaired vision, eye redness and swelling, and sinus congestion if DAVFs are located near the eye.

According to Research work performed by Yong-Hwi An, published in Scientific Reports in 2016 considering that pulsatile tinnitus may be the only initial symptom in more than 10% of DAVF, not only otolaryngologists but also neurologists and neurosurgeons should meticulously evaluate patients with pulsatile tinnitus (PT). In most cases, PT originating from DAVF can be cured with transarterial embolization regardless of location and venous drainage pattern.

Location

Most commonly found adjacent to dural sinuses in the following locations:

1.     Transverse (lateral) sinus, left-sided slightly more common than right

2.     Intratentorial

3.     From the posterior cavernous sinus, usually draining to the transverse or sigmoid sinuses

4.     Vertebral artery (posterior meningeal branch)

Causes:

It is still unclear whether DAVFs are congenital or acquired. Current evidence supports transverse-sigmoid sinus junction dural malformations are acquired defects, occurring in response to thrombosis and collateral revascularization of a venous sinus.

Classification:

Borden Classification

The Borden Classification of dural arteriovenous malformations or fistulas, groups into three types based upon their venous drainage:

1.     Type I: dural arterial supply drains anterograde into venous sinus.

2.     Type II: dural arterial supply drains into venous sinus. High pressure in sinus results in both anterograde drainage and retrograde drainage via subarachnoid veins.

3.     Type III: dural arterial supply drains retrograde into subarachnoid veins.

Epidemiology

10-15% of intracranial AV malformations are DAVFs. There is a higher preponderance in females (61-66%), and typically patients are in their fourth or fifth generation of life. DAVFs are rarer in children.

The following tests may be used to diagnose dural arteriovenous fistulae (DAVF) and help identify its size, location and blood-flow pattern.

·         Cerebral Angiography — This X-ray shows the structure of blood vessels and is the most important test in diagnosing DAVF. A harmless dye, visible on X-rays, is injected into an artery that supplies blood to the brain. As the dye flows through blood vessels to the brain, it will show any obstructions or leaks.

·         Computed Tomography (CT) Scan — During this test, X-ray beams are used to create a 3-D image of the brain and may help identify any bleeding or hemorrhage. For more precise images of blood vessels, the cerebral angiography and magnetic resonance angiography (MRA) are performed.

·         Magnetic Resonance Angiography (MRA) — An MRA uses magnetic resonance imaging to create detailed images of blood vessels. Using a strong magnetic field, it generates a 3-D image of the brain to detect, diagnose and aid the treatment of DAVFs and other vascular disorders. In some cases, a dye is injected intravenously.

Treatments for Dural Arteriovenous Fistula (DAVF)

It is important to tailor management of DAVF to each patient. Specific goals should be put forward taking into account the natural history of the lesion (which mainly depends on its venous drainage pattern), its specific anatomical features and the patient's symptoms. Treatment depends on the drainage pattern of the dural arteriovenous fistula, blood vessels involved and related symptoms.

Endovascular techniques, which are minimally invasive procedures that are performed through the blood vessels, have been developed to safely treat DAVFs.

Embolization, reduces blood flow to the DAVF by obstructing surrounding blood vessels. During this procedure, the DAVF is filled with specially designed coils, glues or spheres that plug the vessels.

Surgery, some fistulas may require surgery to disconnect or close them. In some cases, doctors may try to close the fistula with what's called stereotactic radiosurgery or the Gamma Knife. During microsurgical resection, a craniotomy can be performed and using the microscope isolates the DAVF from the tissues around the brain or spinal cord.

According to Research work performed by Chad J. Cooper, published in American Journal of Case Reports in 2013 a cerebral angiography is the gold standard for detection and characterization of a DAVF and will distinguish it from a CCF. Endovascular surgery involves a catheter-based technique for embolization of the lumen of arteries feeding the DAVF, or directly into the vein draining the DAVF. It is very important to recognize the typical findings of patients presenting with a DAVF then quickly proceeding with a cerebral angiogram to determine the exact location of the fistula and the appropriate treatment plan. By diagnosing and treating a DAVF as early as possible, the associated fatal complications can be averted.

References:

1.      Chad J. Cooper, Sarmad Said, Angelica Nunez, Raphael Quansah, Sayeed Khalillullah, and German T. Hernandez. Dural arteriovenous fistula discovered in patient presenting with recent head trauma. Am J Case Rep. 2013; 14: 444-448.

2.      Web source: http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/cerebrovascular/conditions/arteriovenous_fistula_davf.html. accessed on 05.09.2017.

3. Yong-Hwi An, Sungjun Han, Minhyung Lee, Jihye Rhee, O-Ki Kwon, Gyojun Hwang, Cheolkyu Jung , Yun Jung Bae, Gwang Seok An, Kyogu Lee , Ja-Won Koo & Jae-Jin Song. Dural arteriovenous fistula masquerading as pulsatile tinnitus: radiologic assessment and clinical implications. Scientific Reports 2016; 6: 1-8.

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