Percutaneous transvenous embolization of transverse / sigmoid sinus dural arteriovenous fistula through the mastoid emissary vein: case report

Patients with dural arteriovenous fistulas (DAVFs) in the transverse-sigmoid sinus suffer from several symptoms: bruit, headache, visual impairment, and so on. But depression is rare in patients with DAVF. The authors reported a rare case presenting the improvement of depression after the treatment of a dural arteriovenous fistula in the left transverse-sigmoid sinus. A 46-year-old male had suffered from depression and was treated with antidepressants at a local hospital for four years. The patient was temporarily laid off due to his depression. Afterwards, he had Gerstmann's syndrome and came to our hospital. A DAVF in the left transverse-sigmoid sinus was demonstrated on the angiogram. The DAVF was successfully treated with endovascular surgery, coil embolization of the isolated diseased sinus through the mastoid emissary vein which was a draining vein from the fistula. After this treatment, his depression as well as Gerstmann's syndrome was improved and the quantity of the antidepressants decreased. The patient returned to work without any antidepressant two years after the treatment. DAVFs might be one of the causes of depression. It may be necessary to evaluate cerebral vessels in patients suffering from depression by using MRA or 3D-CTA even if there are not any abnormal findings on plain CT scans.

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A Case of Transverse Sinus Dural Arteriovenous Fistula Treated by Transvenous Embolization via the Mastoid Emissary Vein with Femoral Venous Approach

Journal of Neuroendovascular Therapy ◽

10.5797/jnet.cr.2018-0049 ◽

2019 ◽

Vol 13 (1) ◽

pp. 32-37

Author(s):

Kohei Tokuyama ◽

Hiro Kiyosue ◽

Yuzo Hori ◽

Hirofumi Nagatomi ◽

Yoshiyuki Wakugawa ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Transverse Sinus ◽

Transvenous Embolization ◽

Emissary Vein ◽

Mastoid Emissary Vein

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Retrieval of a migrated N-butyl-2 cyanoacrylate cast using a snare-kit system during dural AVF embolization: A case report

Interventional Neuroradiology ◽

10.1177/1591019918775957 ◽

2018 ◽

Vol 24 (5) ◽

pp. 571-573

Author(s):

Ramy Ahmed ◽

Satomi Ide ◽

Hiro Kiyosue ◽

Shuichi Tanoue ◽

Shunro Matsumoto ◽

...

Keyword(s):

Case Report ◽

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Endovascular Procedures ◽

Sigmoid Sinus ◽

Embolic Material ◽

Coagulation Profile ◽

Liquid Embolic

N-butyl-2 cyanoacrylate (NBCA) is a liquid embolic material that is widely used in various endovascular procedures because of its permanent and rapid vascular occluding effect regardless of the coagulation profile of the patient. However, NBCA migration to unintended vessels may result in serious complications. This report describes the retrieval of a migrated NBCA cast from the transverse-sigmoid sinus during dural arteriovenous fistula embolization using a transvenous snaring technique.

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Arterial Spin Labeling Was Useful for Evaluating the Treatment Response of a Transverse–Sigmoid Sinus Dural Arteriovenous Fistula: A Case Report

Journal of Neuroendovascular Therapy ◽

10.5797/jnet.cr.2019-0119 ◽

2020 ◽

Author(s):

Masatoshi Iwamura ◽

Hiroshi Midorikawa ◽

Akihisa Kakuta ◽

Koichi Shibutani

Keyword(s):

Case Report ◽

Arteriovenous Fistula ◽

Treatment Response ◽

Arterial Spin Labeling ◽

Dural Arteriovenous Fistula ◽

Spin Labeling ◽

Sigmoid Sinus

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Transvenous Embolization of Cavernous Sinus Dural Arteriovenous Fistula Using the Direct Superior Ophthalmic Vein Approach: A Case Report

Neurointervention ◽

10.5469/neuroint.2011.6.2.100 ◽

2011 ◽

Vol 6 (2) ◽

pp. 100 ◽

Cited By ~ 5

Author(s):

Jong Geun Ha ◽

Hae Woong Jeong ◽

Hyun Sin In ◽

Seok Jin Choi

Keyword(s):

Case Report ◽

Arteriovenous Fistula ◽

Cavernous Sinus ◽

Dural Arteriovenous Fistula ◽

Transvenous Embolization ◽

Superior Ophthalmic Vein

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A Case of Sigmoid Sinus Dural Arteriovenous Fistula after Treated Cavernous Dural Arteriovenous Fistula

Interventional Neuroradiology ◽

10.1177/15910199980040s145 ◽

1998 ◽

Vol 4 (1_suppl) ◽

pp. 219-222 ◽

Cited By ~ 8

Author(s):

T. Makiuchi ◽

K. Takasaki ◽

M. Yamagami ◽

H. Oda ◽

K. Todoroki ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Clinical Symptoms ◽

Sigmoid Sinus ◽

External Carotid ◽

Transvenous Embolization ◽

Superior Ophthalmic Vein ◽

Transfemoral Approach ◽

Sinus Wall

Transvenous embolization has been recommended recently as the primary treatment for symptomatic cavernous dural arteriovenous fistula(dural AVF). We present a case of sigmoid sinus dural AVF which developed after transvenous embolization of cavernous dural AVF A 43-year-old man was admitted to our hospital because of left conjunctival chemosis, exophthalmus and abducens nerve palsy. Cerebral angiograms showed left cavernous dural AVF fed by the bilateral internal and external carotid arteries and draining into the enlarged left superior ophthalmic vein. Transfemoral approach in the cavernous sinus via inferior petrosal sinus (IPS) was difficult because of the occlusive change of IPS. Then, direct canulation of the left superior ophthalmic vein and transvenous embolization using interlocking detachable coils (IDC) were performed. Dural AVF and clinical symptoms were disappeard rapidly after embolization. Six months later, follow-up cerebral angiograms showed development of a dural AVF in the left sigmoid sinus. The pathogenesis of dural AVF remains unclear. We suggest that injury to the sinus wall during endovascular procedures may have provoked the development of dural AVF in our case. Clinical and angiographical follow-up are important.

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