Recurrence of dural arteriovenous fistula of the sigmoid and superior petrosal sinus after treatment of superior sagittal sinus dural arteriovenous fistula: a case report

Abstract

Objiective: We report a rare case of dural arteriovenous fistula (dural AVF) of the left sigmoid and superior petrosal sinus developed after treatment of superior sagittal sinus dural arteriovenous fistula.
Case presentation: A 63-year-old female presented disturbance of consciousness. CT showed intracranial hemorrhage in left frontal and parietal lobes with intraventricular perforation. Angiogram revealed a superior sagittal sinus dural AVF fed by middle meningeal artery (MMA) with cortical venous reflux. Transarterial embolization was performed for reducing flow of feeding artery of MMA. 5 days after TAE, skeletonization was performed and flow control was successful. One year and three months later, angiograph showed recurrence of superior sagittal sinus dural AVF and skeletonization was performed again. Posttreatment angiograph showed obliteration of the dural AVF.
One and a half year later, she presented epilepsy and angiogram showed recurrence of dural AVF of the left sigmoid and superior petrosal sinus. Sinus packing was performed with coils and dural AVF disappeared angiographycally.
Conclusion: Clinical and angiographical follow up for several years are important after treatment of dural AVF.