Abstract
Objective: A case of dural sinus malformation (DSM) in a neonate is reported.
Case presentation: A boy with a prenatal diagnosis of DSM was born by cesarean section at a gestational period of 36 weeks. Birth weight was 2741g and head circumference was 38cm. Chest x-ray showed cardiomegaly and cardiac ultrasound examination demonstrated congestive heart failure. To improve his symptoms, endovascular treatment was performed on Day 0. Angiograms showed a huge venous pouch in the left parieto-occipital region, fed by numerous meningeal arteries. Transarterial embolization using N-butylcyanoacrylate and detachable platinum coils was performed via several meningeal feeders. This resulted in marked improvement of his heart failure. As there was Kasabach-Merritt phenomenon caused by the progression of thrombosis in the venous pouch, repeated blood transfusions were required. Subsequently, transarterial glue embolization and transvenous embolization were performed at the age of 5 and 8 months, respectively. Finally, the venous pouch was occluded with coils. These procedures resulted in a marked reduction of the arteriovenous shunts and shrinkage of the venous pouch. At the age of 21 months, the patient presented with mild developmental delay, but without any neurological deficits.
Conclusion: Staged endovascular treatment by transarterial and transvenous embolization was effective for this case of neonatal DSM.
