ABSTRACT
BACKGROUND: Dural arteriovenous fistula (DAVF) is rare in children. Development theories postulate a response to cerebral sinovenous thrombosis (CSVT) or to venous hypertension. The symptoms are highly nonspecific and depend on lesion location. Standard treatment of thrombosis is based on antithrombotic therapy, while the main therapy for DAVF is embolization. CASE REPORT: An 8-year-old boy presented with headache was diagnosed with CSVT and treated with anticoagulant. He developed tinnitus, mental confusion, and lowering of consciousness. Magnetic resonance imaging showed a DAVF draining through a single stenotic venous sinus. Successful endovascular treatment was performed with arterial embolization of multiple feeders and stent and balloon sinus angioplasty. CONCLUSION: Risk factors associated with sinus thrombosis must be always investigated; endovascular treatment is safe and reasonable in a clinical deterioration scenario.
Subject(s)
Central Nervous System Vascular Malformations/diagnostic imaging , Central Nervous System Vascular Malformations/surgery , Endovascular Procedures/methods , Sinus Thrombosis, Intracranial/diagnostic imaging , Sinus Thrombosis, Intracranial/surgery , Child , Humans , Male , Treatment OutcomeABSTRACT
BACKGROUND: Sinus pericranii (SP) is a rare vascular malformation consisting of an abnormal communication between the extra- and the intracranial venous system. It occurs due to the adhesion of vessels without a muscular layer or a hemangioma on the outer surface of the skull through diploic vessels, communicating with an intracranial venous sinus. CASE DESCRIPTION: A 10-month-old female presented with a pulsatile mass on the posterior parietal region. Investigation with brain vascular examinations showed a venous malformation communicating with the superior sagittal sinus under the scalp, without arterial feeder or nidus. An endovascular embolization with coils and a percutaneous embolization with Onyx ® were performed. The final venography showed complete exclusion of the lesion, which was gradually being absorbed. CONCLUSION: This is the first case of an SP successfully treated in a single session by embolization with coils and onyx.
