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  • Isolated superior petrosal sinus dural arteriovenous fistula treated with selective sinus packing using a quadriaxial catheter system

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Reminder of important clinical lesson
CASE REPORT
Isolated superior petrosal sinus dural arteriovenous fistula treated with selective sinus packing using a quadriaxial catheter system
  1. Yu Okuma,
  2. Nobuyuki Hirotsune,
  3. Kenichiro Muraoka and
  4. Shigeki Nishino
  1. Department of Neurological Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
  1. Correspondence to Dr Yu Okuma, y8u2bear4{at}hotmail.com

Abstract

A 67-year-old patient presented with a headache, vertigo and nausea, followed by a disturbance of consciousness. CT and MRI showed venous ectasia at the left cerebellopontine angle and extensive oedema in the left cerebellum. Angiography demonstrated a dural arteriovenous fistula that appeared at the left superior petrosal sinus–cavernous sinus) junction. After the evaluation of the shunt point, occluded areas were recanalised via the femoral vein with a quadriaxial catheter system using a 6-Fr guiding sheath, 6-Fr guiding catheter, 4.2-Fr catheter and microcatheter. Selective coil embolisation was performed, resulting in shunt removal.

  • neurology (drugs and medicines)
  • headache (including migraines)
  • stroke
  • interventional radiology

https://doi.org/10.1136/bcr-2018-227618

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    Footnotes

    • Contributors The four authors are justifiably credited with authorship. In detail, YO: conception, design, data collection, drafting of the manuscript, writing the article, final approval given; NH : conception, design, analysis and interpretation of data, critical revision of the article, supervision, final approval given; KM: data collection, critical revision of the article, supervision, final approval given; SN: data collection, critical revision of manuscript, final approval given.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.