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Staged embolisation of a giant torcular dural sinus malformation in a neonate
  1. Evan M Luther1,
  2. Aria Jamshidi1,
  3. Hunter King2 and
  4. Robert Starke1
  1. 1Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA
  2. 2Neurological Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Evan M Luther; evan.luther{at}


Torcular dural sinus malformations (tDSMs) represent a rare subset of paediatric cerebrovascular malformations and are often diagnosed antenatally via ultrasound. The management of these in utero lesions remains controversial as previous studies suggested elective termination of the pregnancy because of their presumably high mortality and severe long-term morbidity. However, more recent evaluations have suggested that the overall prognosis for infants harbouring these lesions may be much better than previously believed. As such, we present the case of a neonate with a giant tDSM, diagnosed in utero, who was treated postnatally via staged transarterial and transvenous embolisation to alleviate worsening obstructive hydrocephalus and brainstem compression. We provide details regarding the surgical approach and long-term neurological outcomes for this patient. To the best of our knowledge, this is one of the largest reported tDSM presented in the literature.

  • neuroimaging
  • interventional radiology
  • neurosurgery
  • hydrocephalus
  • congenital disorders

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  • Contributors EML: planning, conduct, reporting, conception and design, acquisition of data, interpretation of data. AJ: reporting, acquisition of data, interpretation of data. HK: reporting, acquisition of data, interpretation of data. RS: planning, conduct, reporting, conception and design, acquisition of data, interpretation of data.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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