Borden classification [Neurosurgery Wiki]

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=====Borden classification=====

The  Borden [[Classification]] of [[dural arteriovenous malformation]]s or fistulas, groups into three types based upon their venous drainage:

{{::duralarteriovenousfistulaclassification.jpg|}}

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

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

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

===== Type I =====
see [[Borden type I intracranial dural arteriovenous fistula]]



===== Type II =====


The high pressure within a Type II dural AV fistula causes blood to flow in a retrograde fashion into  subarachnoid veins which normally drain into the sinus. Typically this  is because the sinus has outflow obstruction. Such draining veins form  venous varices or aneurysms which can bleed. Type II fistulas need to be treated to prevent hemorrhage. The treatment may involve embolisation of the draining sinus as well as clipping or embolization of the draining veins.

Type III

Type III dural AV fistulas drain directly into subarachnoid veins. These veins can form aneurysms and bleed. Type III dural fistulas need  to be treated to prevent hemorrhage. Treatment can be as simple as  clipping the draining vein at the site of the dural sinus. If treatment  involves embolization, it will only typically be effective if the glue  traverses the actual fistula and enters, at least slightly, the draining  vein.