The Journal of Cerebrovascular and Endovascular Neurosurgery

Abstract - Case Report

J Cerebrovasc Endovasc Neurosurg. 2021 23(3): 260-265

Superior sagittal sinus dural arteriovenous fistula caused by treatment of meningioma masquerades as sinus thrombosis

Michael J. Gigliotti, Neel Patel, Scott Simon

Department of Neurosurgery, Penn State Health Milton S Hershey Medical Center, PA, USA

Dural arteriovenous fistulas (DAVF) are rare acquired lesions resulting from abnormal shunting between intracranial dural arteries and venous system. Typically arising from structural weakness of the dura and a coinciding trigger factor, DAVFs can present with similar clinical and imaging characteristics to sinus thrombosis. A 61-year-old male with a history of meningioma previously managed with subtotal resection and stereotactic radiosurgery presented with progressive right-sided vision loss and bilateral papilledema. Initial imaging suggested possible sinus occlusion. Catheter angiogram revealed a Borden-Shucart grade III DAVF of the superior sagittal sinus and elevated venous pressures and the patient subsequently underwent endovascular transarterial intervention twice. We report on the first case of a superior sagittal sinus DAVF occurring after surgical resection of a parasagittal meningioma.

Key words : Superior sagittal sinus, Dural arteriovenous fistula, Meningioma, Endovascular therapy