Brain dural AV fistulas are an under-recognized and under-treated cause of MCI and early dementia as the focus has traditionally been on acute presentations of these patients with neurological deficits, headaches rather than the cognitive impact. Patients are known to present with disorders such as Parkinsonism, MCI and early dementia which can resemble vascular dementia or fronto-temporal dementia. This adversely impacts the quality of life of patients and their family members. Similarly, spinal dural fistula can present with varying degrees of paraparesis to paraplegia, that eventually affect the quality of life of the individual. Both the diseases can be effectively treated by endovascular or uncommonly, surgical approaches.

The understanding of cognitive networks in the brain has been compounded by research into resting-state or 'task-free' blood oxygen level dependent activations in various regions using functional MRI. This has led to the understanding that certain regions of the brain are connected with others and may play a vital role in execution of specific neurological functions. At SCTIMST, specialists routinely rely heavily on MRI to understand the disease, and delineation of angiomorphology prior to subjecting the patient for detailed angiogram and subsequent management. The researcher team also study the impact of brain perfusion dysregulation on connectivity of brain regions concerned with consciousness, focused and sustained attention, visual-verbal memory encoding, executive control, orientation and other cognitive domains. Early diagnosis and timely neurointervention has been demonstrated to improve brain network connectivity among regions concerned with memory as well as processing speed and executive control. This improvement in connectivity positively correlates with neuropsychology test score performances and at a functional level to better quality of life for patients with this eminently treatable cognitive disorder. Neurointerventional radiologists perform complex endovascular procedures (transarterial or transvenous approaches) routinely for the effective treatment of dural arteriovenous fistula.

Ongoing Projects
  1. Alterations in resting-state functional MRI connectivity related to cognitive changes in intracranial dural arteriovenous fistulas before and after embolisation treatment, supported by CSRI, DST, GoI
  2. Artificial intelligence for detection of dural fistula from susceptibility weighted imaging
  3. Non-contrast MR techniques for evaluation of cranial dural fistula
  4. Perfusion MRI and SWI characterisation of cranial dural fistula
  1. Sabarish S, Kannath SK, Ramachandran S, Menon RN, Thomas B. Alterations in resting-state functional MRI connectivity related to cognitive changes in intracranial dural arteriovenous fistulas before and after embolization treatment. J Magn Reson Imaging 2021,doi: 10.1002/jmri.27936.
  2. Balasubramaniam AP, Kannath SK, Rajan JE, Singh G, Kesavadas C, Thomas B. Utility of silent magnetic resonance angiography in the evaluation and characterisation of intracranial dural arteriovenous fistula. Clin Radiol2021;76:712.e1-712.e8.
  3. Joseph JE, Sekar S, Kannath SK, Menon RN, Thomas B. Impaired intrinsic functional connectivity among medial temporal lobe and sub-regions related to memory deficits in intracranial dural arteriovenous fistula. Neuroradiology 2021;63:1679-1687.
  4. Jaganmohan D, Pan S, Kesavadas C, Thomas B. A pictorial review of brain arterial spin labelling artefacts and their potential remedies in clinical studies.Neuroradiol J. 2021;34:154-168.
  5. Kannath SK, Mandapalu S, Thomas B, Rajan JE, Kesavadas C. Comparative analysis of volumetric high-resolution heavily T2-weighted MRI and time-resolved contrast-enhanced MRA in the evaluation of spinal vascular malformations.AJNR Am J Neuroradiol. 2019;40:1601-1606.
  6. Kannath SK, Rajendran A, Thomas B, Rajan JE. Volumetric T2-weighted MRI improves the diagnostic accuracy of spinal vascular malformations: comparative analysis with a conventional MR study. J Neurointerv Surg. 2019;11:1019-1023.
  7. Mandapalu S, Kannath S, Kesavadas C. Fusion imaging of Time Resolved Imaging of Contrast KineticS (TRICKS) and high resolution volumetric T2 MR sequences in the evaluation of spinal vascular malformations. J Neuroradiol.2019;46:276-277.
  8. Kannath SK, Thomas B, Sarma SP, Rajan JE. Impact of non-contrast enhanced volumetric MRI-based feeder localization in the treatment of spinal dural arteriovenous fistula.J Neurointerv Surg. 2017;9:178-182.
  9. Jain NK, Kannath SK, Kapilamoorthy TR, Thomas B. The application of susceptibility-weighted MRI in pre-interventional evaluation of intracranial dural arteriovenous fistulas.J Neurointerv Surg. 2017;9:502-507.
  10. Kannath SK, Rajan JE, Mukherjee A, Sarma SP. Factors predicting spontaneous thrombosis of aggressive cranial dural arteriovenous fistulas.World Neurosurg.2017;103:821-828.
  11. \ Kannath SK, Rajan JE, Sarma SP. Anatomical localization of the cavernous sinus dural fistula by 3D rotational angiography with emphasis on clinical and therapeutic implications.J Neuroradiol. 2017;44:326-332
  12. Gopinath M, Nagesh C, Kannath S, Jayadevan ER. Dementia and Parkinsonism-a rare presentation of intracranial dural arteriovenous fistulae. Neurointervention.2017;12(2):125-129.
  13. Kannath SK, Alampath P, Rajan JE, Thomas B, Sarma SP, Raman KT. Utility of 3D SPACE T2-weighted volumetric sequence in the localization of spinal dural arteriovenous fistula.J Neurosurg Spine. 2016;25:125-32
  14. Mohimen A, Kannath SK, Rajan JE. The Retrocorporeal Artery: An Alternative Route for Endovascular Treatment of Spinal Dural Arteriovenous Fistula.ournal of Clinical Interventional Radiology ISVIR 2017; 01(03): 168-170
  15. Mohimen A, Kannath SK, Rajan JE. Skull base osseous arteriovenous fistula—a rare clinical entity: case report and literature review.World Neurosurg. 2017;97:760.e9-760.e12
  16. Vinayagamani S, Kannath SK, Rajan JE. Recurring Thalamic Symptoms Due to Intracranial Dural Arteriovenous Fistula: Report of Unusual Case and Treatment Outcome.World Neurosurg. 2018;118:9-13.
  17. Mohimen A, Kannath SK, Jayadevan ER, Jain NK, Kapilamoorthy TR. Spinal venous hypertension secondary to pelvic extra-spinal arteriovenous fistula—a previously unreported cause of congestive myelopathy. Spine J. 2016;16(2):e41-2.
  18. Kannath SK, Rajan JE. The Lurking Catastrophic Complication of an Equally Catastrophic Disease: The Lesson Learned. Oper Neurosurg. 2016;12:189-192.