Surgery of Arterio-Sphenoparietal Sinus Fistula

A 7-month-old boy was presented with growth retardation. The brain CT scan and the cerebral angiography revealed hydrocephalus resulting from venous hypertension and a high-flow direct arteriovenous fistula at the distal M2 segmnt of the middle cerebral artery which was drained into the sphenoparietal sinus. The echocardiogram disclosed a ventricular hypertrophy. The patient was treated by gradual ligation of fistulous portion in ten minutes to prevent sudden increase of peripheral resistance and cardiac overloading. It is stressed that slow obliteration of an arteriovenous fistula is a paramount procedure to prevent congestive heart failure.