Hostname: page-component-848d4c4894-p2v8j Total loading time: 0.001 Render date: 2024-05-27T13:11:12.327Z Has data issue: false hasContentIssue false

Pediatric Traumatic Dural Arteriovenous Fistula

Published online by Cambridge University Press:  02 December 2014

Michael Vassilyadi*
Affiliation:
Division of Neurosurgery, Children's Hospital of Eastern Ontario Division of Neurosurgery, The Ottawa Hospital, Ottawa, Canada
Naveen Mehrotra
Affiliation:
Division of Neurosurgery, Children's Hospital of Eastern Ontario
Mohammed F. Shamji
Affiliation:
Division of Neurosurgery, The Ottawa Hospital, Ottawa, Canada
Jean Michaud
Affiliation:
Division of Anatomic Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Canada
*
The Children’s Hospital of Eastern Ontario, Division of Neurosurgery, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada.
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Dural arteriovenous fistulas are uncommon lesions in children, with traumatic lesions suspected to arise from incomplete arterial injury in proximity to a vein or draining sinus. Management of symptomatic acquired lesions requires evaluation of patient presentation, neurological status, and pathoanatomic configuration, with special consideration required for surgery secondary to failed endovascular technique.

Case Report:

A 12-year-old male sustained a bicycle fall causing a right temporo-parietal skull fracture associated with non-surgical right epidural hematoma and left contre-coup parietal contusion. Six-weeks later, he complained of a right temporal bruit with subsequent cerebral angiography demonstrating a dural-based fistula between the right middle meningeal artery and a dural vein draining into the sigmoid sinus.

Intervention:

Endovascular treatment of this lesion with glue embolization and coiling was unsuccessful, with angiographic illustration of previously unobserved collateral vessels and coils occupying the sigmoid sinus. A right temporo-parietal craniectomy was required to excise the dural-based fistula, followed by dural defect repair with bovine pericardium and subsequent cranioplasty. Six years later the patient remains neurologically intact with no headaches or bruit.

Conclusions:

Dural arteriovenous fistula can uncommonly occur following traumatic injury in children. Partial injury to the middle mengineal artery may have established arterial communication with the draining vein that became ectatic and tortuous under high pressure. Failure of primary endovascular treatment may complicate secondary surgical intervention.

Type
Other
Copyright
Copyright © The Canadian Journal of Neurological 2009

References

1.Cognard, C, Gobin, YP, Pierot, L, Bailly, AL, Houdart, E, Casasco, A, et al.Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Radiology. 1995 Mar;194(3):67180.CrossRefGoogle ScholarPubMed
2.Kincaid, PK, Duckwiler, GR, Gobin, YP, Vinuela, F.Dural arteriovenous fistula in children: endovascular treatment and outcomes in seven cases. AJNR Am J Neuroradiol. 2001 Jun-Jul;22(6):121725.Google ScholarPubMed
3.Chaloupka, JC.Endovascular therapy for dural arteriovenous fistulae. Seminars in Interventional Radiology. 1994;11:113.CrossRefGoogle Scholar
4.Lasjaunias, P, Magufis, A, Goulao, A, Suthipongchai, S, Rodesch, R, Alvarez, H.Anatomoclinical aspects of dural arteriovenous shunts in children. Interventional Neuroradiology. 1996;2:17991.CrossRefGoogle ScholarPubMed
5.Morita, A, Meyer, FB, Nichols, DA, Patterson, MC.Childhood dural arteriovenous fistulae of the posterior dural sinuses: three case reports and literature review. Neurosurgery. 1995 Dec;37(6): 11939; discussion 1199-200.CrossRefGoogle ScholarPubMed
6.Garcia-Monaco, R, Rodesch, G, Terbrugge, K, Burrows, P, Lasjaunias, P.Multifocal dural arteriovenous shunts in children. Childs Nerv Syst. 1991 Dec;7(8):42531.CrossRefGoogle ScholarPubMed
7.Roland, J, Bernard, C, Bracard, S, Czorny, A, Floquet, J, Race, JM, et al.Microvascularization of the intracranial dura mater. Surg Radiol Anat. 1987;9(1):439.CrossRefGoogle ScholarPubMed
8.Satomi, J, van Dijk, JM, Terbrugge, KG, Willinsky, RA, Wallace, MC.Benign cranial dural arteriovenous fistulas: outcome of conservative management based on the natural history of the lesion. J Neurosurg. 2002 Oct;94(4):76770.CrossRefGoogle Scholar
9.Strom, RG, Botros, JA, Refai, D, Moran, CJ, Cross, DT, 3rd, Chicoine, MR, et al.Cranial dural arteriovenous fistulae: asymptomatic cortical venous drainage portends less aggressive clinical course. Neurosurgery. 2009 Feb;64(2):2417; discussion 247-8.CrossRefGoogle ScholarPubMed
10.Davies, MA, TerBrugge, K, Willinsky, R, Coyne, T, Saleh, J, Wallace, MC.The validity of classification for the clinical presentation of intracranial dural arteriovenous fistulas. J Neurosurg. 1996 Nov;85(5):8307.CrossRefGoogle ScholarPubMed
11.Kitahara, T, Shirai, S, Owada, T, Maki, Y.Traumatic middlemeningeal arteriovenous fistula. Report of 3 cases and analysis of 32 cases. Eur Neurol. 1977;16(1-6):13643.CrossRefGoogle Scholar
12.Wilson, CB, Cronic, F.Traumatic arteriovenous fistulas involving middle meningeal vessels. JAMA. 1964 Jun 15;188:9537.CrossRefGoogle ScholarPubMed
13.Borden, JA, Wu, JK, Shucart, WA.A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment. J Neurosurg. 1995 Feb;82(2): 16679.CrossRefGoogle ScholarPubMed
14.Cognard, C, Januel, AC, Silva, NA Jr, Tall, P.Endovascular treatment of intracranial dural arteriovenous fistulas with cortical venous drainage: new management using Onyx. AJNR Am J Neuroradiol. 2008 Feb;29(2):23541.CrossRefGoogle ScholarPubMed
15.Houdart, E, Saint-Maurice, JP, Chapot, R, Ditchfield, A, Blanquet, A, Lot, G, et al.Transcranial approach for venous embolization of dural arteriovenous fistulas. J Neurosurg. 2002 Aug;97(2):2806.CrossRefGoogle ScholarPubMed
16.Roy, D, Raymond, J.The role of transvenous embolization in the treatment of intracranial dural arteriovenous fistulas. Neurosurgery. 1997 Jun;40(6):113341; discussion 1141-4.CrossRefGoogle ScholarPubMed
17.Klisch, J, Huppertz, HJ, Spetzger, U, Hetzel, A, Seeger, W, Schumacher, M.Transvenous treatment of carotid cavernous and dural arteriovenous fistulae: results for 31 patients and review of the literature. Neurosurgery. 2003 Oct;53(4):83656; discussion 856-7.CrossRefGoogle ScholarPubMed
18.Oishi, H, Arai, H, Sato, K, Iizuka, Y.Complications associated with transvenous embolisation of cavernous dural arteriovenous fistula. Acta Neurochir (Wien). 1999;141(12):126571.CrossRefGoogle ScholarPubMed
19.Bavinzski, G, Richling, B, Killer, M, Gruber, A, Levy, D.Evolution of different therapeutic strategies in the treatment of cranial dural arteriovenous fistulas-report of 30 cases. Acta Neurochir (Wien). 1996;138(2):1328.CrossRefGoogle ScholarPubMed
20.Barnwell, SL, Halbach, VV, Higashida, RT, Hieshima, G, Wilson, CB.Complex dural arteriovenous fistulas. Results of combined endovascular and neurosurgical treatment in 16 patients. J Neurosurg. 1989 Sep;71(3):3528.CrossRefGoogle ScholarPubMed
21.Lawton, MT, Chun, J, Wilson, CB, Halbach, VV.Ethmoidal dural arteriovenous fistulae: an assessment of surgical and endovascular management. Neurosurgery. 1999 Oct;45(4):80510; discussion 810-11.CrossRefGoogle ScholarPubMed
22.Halbach, VV, Higashida, RT, Hieshima, GB, Wilson, CB, Barnwell, SL, Dowd, CF.Dural arteriovenous fistulas supplied by ethmoidal arteries. Neurosurgery. 1990 May;26(5):81623.CrossRefGoogle ScholarPubMed
23.Kawaguchi, T, Hosoda, K, Shibata, Y, Kidoguchi, K, Koyama, J, Tamaki, N.Direct surgical removal of the dural arteriovenous fistula involving the transverse-sigmoid sinuses. J Clin Neurosci. 2002;9(S1):1618.Google ScholarPubMed
24.Ushikoshi, S, Houkin, K, Kuroda, S, Asano, T, Iwasaki, Y, Miyasaka, K, et al.Surgical treatment of intracranial dural arteriovenous fistulas. Surg Neurol. 2002 Apr;57(4):25361.CrossRefGoogle ScholarPubMed
25.Goto, K, Sidipratomo, P, Ogata, N, Inoue, T, Matsuno, H.Combining endovascular and neurosurgical treatments of high-risk dural arteriovenous fistulas in the lateral sinus and the confluence of the sinuses. J Neurosurg. 1999 Feb;9(2):28999.CrossRefGoogle Scholar
26.Kakarla, UK, Deshmukh, VR, Zabramski, JM, Albuquerque, FC, McDougall, CG, Spetzler, RF.Surgical treatment of high-risk intracranial dural arteriovenous fistulae: clinical outcomes and avoidance of complications. Neurosurgery. 2007 Sep;61(2):44757; discussion 457-9.CrossRefGoogle ScholarPubMed
27.Kong, DS, Kwon, KH, Kim, JS, Hong, SC, Jeon, P.Combined surgical approach with intraoperative endovascular embolization for inaccessible dural arteriovenous fistulas. Surg Neurol. 2007 Jul;68(1):727; discussion 78.CrossRefGoogle ScholarPubMed
28.Pan, HC, Sheehan, J, Huang, CF, Yang, DY.Two consecutive dural arteriovenous fistulae in a child: a case report of successful treatment with gamma knife radiosurgery. Childs Nerv Syst. 2007 Oct;23(10):118590.CrossRefGoogle Scholar
29.van Dijk, JM, terBrugge, KG, Willinsky, RA, Wallace, MC.Clinical course of cranial dural arteriovenous fistulas with long-term persistent cortical venous reflux. Stroke. 2002 May;33(5): 12336.CrossRefGoogle ScholarPubMed
30.Soderman, M, Edner, G, Ericson, K, Karlsson, B, Rahn, T, Ulfarsson, E, et al.Gamma knife surgery for dural arteriovenous shunts: 25 years of experience. J Neurosurg. 2006 Jun;104(6):86775.CrossRefGoogle ScholarPubMed
31.Friedman, JA, Pollock, BE, Nichols, DA, Gorman, DA, Foote, RL, Stafford, SL.Results of combined stereotactic radiosurgery and transarterial embolization for dural arteriovenous fistulas of the transverse and sigmoid sinuses. J Neurosurg. 2001 Jun;94(6): 88691.CrossRefGoogle ScholarPubMed
32.Link, MJ, Coffey, RJ, Nichols, DA, Gorman, DA.The role of radiosurgery and particulate embolization in the treatment of dural arteriovenous fistulas. J Neurosurg. 1996 May;85(5):8049.CrossRefGoogle Scholar
33.Heros, RC.Gamma knife surgery for dural arteriovenous fistulas. J Neurosurg. 2006 Jun;104(6):8613; discussion 865-6.CrossRefGoogle ScholarPubMed