Gradual dilatation of an occluded transverse sinus associated with dural arteriovenous fistula after balloon angioplasty with sinus packing: A case report.
Balloon angioplasty
dilatation
dural arteriovenous fistula
occlusion
Journal
The neuroradiology journal
ISSN: 2385-1996
Titre abrégé: Neuroradiol J
Pays: United States
ID NLM: 101295103
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
pubmed:
24
8
2021
medline:
11
6
2022
entrez:
23
8
2021
Statut:
ppublish
Résumé
There is no consensus as to whether balloon angioplasty alone or stent placement is effective for sinus occlusion associated with dural arteriovenous fistula (DAVF). Herein, we first report a case of transverse sinus occlusion associated with DAVF in which gradual sinus dilatation was observed after balloon angioplasty with embolization of the affected sinus with shunt flow. A 69-year-old man presented with executive dysfunction. Magnetic resonance imaging revealed left transverse sinus-sigmoid sinus DAVF with occlusion of the left jugular vein and right transverse sinus. Before endovascular treatment, the patient had symptomatic epilepsy and subarachnoid hemorrhage. Retrograde leptomeningeal venous drainage disappeared with packing of the left transverse sinus-sigmoid sinus. Subsequently, balloon angioplasty of the right occluded transverse sinus was performed to maintain the normal venous drainage and remaining shunt outflow. Dilatation of the right transverse sinus was poor immediately after surgery. However, angiography after 10 days and 6 months revealed gradual dilatation of the right transverse sinus. Sinus occlusion, which is thought to be caused by sinus hypertension associated with DAVF rather than chronic organized thrombosis or thrombophilia, may dilate over time after balloon angioplasty and shunt flow reduction if occluded sinus is necessary for facilitating normal venous drainage.
Sections du résumé
BACKGROUND
BACKGROUND
There is no consensus as to whether balloon angioplasty alone or stent placement is effective for sinus occlusion associated with dural arteriovenous fistula (DAVF). Herein, we first report a case of transverse sinus occlusion associated with DAVF in which gradual sinus dilatation was observed after balloon angioplasty with embolization of the affected sinus with shunt flow.
CASE PRESENTATION
METHODS
A 69-year-old man presented with executive dysfunction. Magnetic resonance imaging revealed left transverse sinus-sigmoid sinus DAVF with occlusion of the left jugular vein and right transverse sinus. Before endovascular treatment, the patient had symptomatic epilepsy and subarachnoid hemorrhage. Retrograde leptomeningeal venous drainage disappeared with packing of the left transverse sinus-sigmoid sinus. Subsequently, balloon angioplasty of the right occluded transverse sinus was performed to maintain the normal venous drainage and remaining shunt outflow. Dilatation of the right transverse sinus was poor immediately after surgery. However, angiography after 10 days and 6 months revealed gradual dilatation of the right transverse sinus.
CONCLUSION
CONCLUSIONS
Sinus occlusion, which is thought to be caused by sinus hypertension associated with DAVF rather than chronic organized thrombosis or thrombophilia, may dilate over time after balloon angioplasty and shunt flow reduction if occluded sinus is necessary for facilitating normal venous drainage.
Identifiants
pubmed: 34423659
doi: 10.1177/19714009211041529
pmc: PMC9244740
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
388-395Références
Neuroradiology. 1997 Jan;39(1):59-66
pubmed: 9121651
J Neurosurg. 1994 May;80(5):884-9
pubmed: 8169629
J Neurosurg. 2018 Oct;129(4):954-960
pubmed: 29148899
World Neurosurg. 2018 Jun;114:269-273
pubmed: 29602009
AJNR Am J Neuroradiol. 2017 Jan;38(1):132-138
pubmed: 27765737
Clin Neuroradiol. 2019 Jun;29(2):331-339
pubmed: 29243076
Neuroradiology. 2003 Dec;45(12):911-5
pubmed: 14605788
J Neurosurg. 2015 May;122(5):1208-13
pubmed: 25679278
J Neurosurg. 2006 Feb;104(2):254-63
pubmed: 16509499
AJNR Am J Neuroradiol. 2004 Jun-Jul;25(6):1086-8
pubmed: 15205154
J Neurosurg. 2018 Apr 1;:1-5
pubmed: 29624150
Stroke. 2017 May;48(5):1424-1431
pubmed: 28432263