Childhood transverse sinus dural arteriovenous fistula treated with endovascular and direct surgery: A case report

Kuniyasu Niizuma, Hiroyuki Sakata, Shinya Koyama, Hiroyuki Kon, Masashi Chonan, Tatsuya Sasaki, Michiharu Nishijima, Masayuki Ezura, Teiji Tominaga

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Infantile dural arteriovenous fistula is a rare cerebrovascular malformation carrying a poor prognosis with an anatomic cure of only 9%. Endovascular embolization is mainly selected to treat this entity, aiming to obtain normal development of the patients. We present a case of a 20-month-old girl with epilepsy. Digital subtraction angiography revealed a dural arteriovenous fistula involving the right transverse sinus. The artenovenous fistula was fed by multiple dural branches from the middle meningeal, occipital, meningohypophyseal. and anteroinferior cerebellar arteries. The right transverse sinus was transvenously embolized with platinum coils. Although the shunt flow remained, the patient was liberated from epilepsy. Nine months later, the patient suffered from a recurrence of epilepsy. Digital subtraction angiography demonstrated some increase in shunt flow. Right middle meningeal, occipital, posterior deep temporal, and tentorial arteries were transarterially embolized using N-butyl cyanoacrylate, followed by complete surgical resection of the nght transverse sinus. The shunt flow disappeared after surgery, and her epilepsy improved significantly. Our experience suggests that the combination of endovascular and surgical treatment is effective for recurrent infantile dural arteriovenous fistula.

Original languageEnglish
Pages (from-to)1015-1020
Number of pages6
JournalNeurological Surgery
Volume40
Issue number11
Publication statusPublished - 2012 Nov

Keywords

  • Infantile dural arteriovenous fistula
  • Infantile dural arteriovenous shunt
  • Sinus occlusion
  • Sinus resection
  • Symptomatic epilepsy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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  • Cite this

    Niizuma, K., Sakata, H., Koyama, S., Kon, H., Chonan, M., Sasaki, T., Nishijima, M., Ezura, M., & Tominaga, T. (2012). Childhood transverse sinus dural arteriovenous fistula treated with endovascular and direct surgery: A case report. Neurological Surgery, 40(11), 1015-1020.