2020 Volume 29 Issue 3 Pages 207-214
We report an unusual case with de novo development of anterior condylar confluence dural arteriovenous fistula (ACC-DAVF) and transverse-sigmoid (TS) DAVF one year after endovascular treatment of cavernous sinus (CS) DAVF. A 74-year-old female was admitted to our hospital after presenting with headache. The diagnostic magnetic resonance imaging and digital subtraction angiography (DSA) revealed CS-DAVF (Borden type III). Transvenous embolization (TVE) for this lesion failed, but DSA at two weeks after the intervention showed disappearance of the CS-DAVF and occlusion of the ipsilateral sigmoid sinus. However, one-year follow-up DSA revealed de novo ipsilateral ACC-DAVF (Borden type I) and TS-DAVF (Borden type II). TVE and transarterial embolization (TAE) were successfully performed for the TS-DAVF. No recurrence was seen at the one-year follow-up.
After treatment of a DAVF, especially combined with iatrogenic occlusion of sigmoid sinus, de novo DAVFs may occur at other sites. Thus, careful radiological follow-up is recommended.
