Transarterial Embolization from a Pial Feeder of Tentorial Dural Arteriovenous Fistula

Abstract

Objective: We report a case of endovascular management of a tentorial dural arteriovenous fistula (dAVF) with a pial feeder.

Case presentation: A 36-year-old man presented with a headache and alexia. Angiograms revealed a tentorial dAVF, which was supplied by both pial and dural feeders and drained directly into the leptomeningeal vein. Transarterial embolization (TAE) with n-butyl-2-cyanoacrylate via the pial feeder from the left posterior cerebral artery completely obliterated the shunt without complications.

Conclusion: TAE of dural feeders in dAVF with both pial and dural feeders has a significant risk of severe hemorrhagic complications. To avoid these complications, TAE of pial feeders should precede TAE of dural feeders.