Anat Cell Biol.  2021 Dec;54(4):518-521. 10.5115/acb.21.083.

Giant dural arteriovenous fistula in an infant

• Peper C
• Iwanaga J
• Dumont AS
• Tubbs RS

• KMID: 2523581
• DOI: http://doi.org/10.5115/acb.21.083

Abstract

Dural arteriovenous fistulas (dAVFs) are commonly encountered by the neurosurgeon. Herein, we present a case illustration of an infant presenting with an extremely large fistula that took up a significant part of the intracranial volume. A one-month-old female presented with irritability and failure to thrive. She was the product of a 35-week pregnancy and was delivered vaginally without complications or a difficult labor. Based on the findings of magnetic resonance imaging, the diagnosis of a giant dAVF involving the transerve-sigmoid sinuses was made. The patient was scheduled for an arteriogram but died before the procedure could be performed. Such a case illustrates how large some dAVF can become and at a very early age. As in the present case, the patient was minimally symptomatic. Therefore, the time to intervention after diagnosis is thus, sometimes, critical.

Keyword

Dural arteriovenous fistula; Infant; Dural venous sinus

Figure

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  Fig. 1 (A) T1-weighted magnetic resonance imaging (MRI) noting the large intracranial mass. Hydrocephalus is evident in the lateral ventricles. (B) T1-weighted MRI noting the compression of the contents of the posterior cranial fossa. (C) T1-weighted MRI noting the large intracranial mass filling most of the posterior cranial fossa. Hydrocephalus is evident in the temporal horns. (D) Axial image noting the dilated ventricular system. Hydrocephalus is evident in the third ventricle. (E) Scout image illustrating the giant mass and dilated internal jugular veins (lower arrows). Note the superior sagittal sinus at the upper arrow. (F) Note the normal appearance of the components of the circle of Willis and vertebrobasilar system.

Reference

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