Non-sinus-type Dural Arteriovenous Fistula Cured by Transarterial Embolization from Middle Meningeal Artery: Two Case Reports

Abstract

Objective: We report two cases of non-sinus-type dural arteriovenous fistula (dAVF) cured by transarterial embolization (TAE) alone.

Case Presentations: Case 1: A 55-year-old male presented with tinnitus and MRI showed dilated abnormal vessels and a varix in the right frontal lobe. Angiograms revealed a right parasagittal dAVF, supplied by the bilateral frontal branch of middle meningeal artery (MMA) without direct drainage into the superior sagittal sinus (SSS). Case 2: A 62-year-old male presented with headache and hemianopia and CT showed intracranial hemorrhage in the right occipital lobe. Angiograms revealed a vault dAVF located at the right occipital convexity, supplied by the squamous branch of the right MMA and the mastoid branch of the occipital artery (OA) without direct drainage into the transverse sinus.

In both cases, we performed TAE with low-concentration n-butyl-2-cyanoacrylate (NBCA) injected from wedged catheters via the MMA and dAVFs were completely disappeared.

Conclusion: In selected cases, transarterial NBCA embolization is a safe, curative method to address dAVF.