Transvenous Embolization for Isolated Superior Petrosal Sinus Dural Arteriovenous Fistula

Abstract

Isolated superior petrosal sinus dural arteriovenous fistula (SPSdAVF) is a rare condition for which transvenous embolization is a safe treatment, even if accessing the isolated sinus can be challenging. A 39-year-old female patient with dizziness and right facial palsy underwent magnetic resonance imaging, revealing a venous infarction at the posterior fossa and a dural arteriovenous fistula. Digital subtraction angiography showed an isolated SPSdAVF. The shunt point was posterior to the isolated superior petrosal sinus, and the shunt flowed only through the petrosal vein. Contrast-enhanced magnetic resonance imaging showed thrombosis at the anterior segment of the superior petrosal sinus. Transvenous embolization was successfully performed via the thrombosed anterior segment of the superior petrosal sinus without associated complications. This case shows that transvenous embolization through a thrombosed superior petrosal sinus is an alternative treatment option for isolated SPSdAVF.