title: Recurrence of the cavernous sinus dural arteriovenous fistula at adjacent sinuses following repeated transvenous embolizations: case report and literature review.
abstract: We present a unique case of a cavernous sinus (CS) dural arteriovenous fistula (DAVF), which recurred at adjacent sinuses following repeated transvenous embolizations (TVEs). A 68-year-old woman presented with progressive left conjunctival chemosis and diplopia. Cerebral angiography revealed a left CS DAVF, which was completely obliterated by TVE via the left inferior petrosal sinus (IPS). Two years later, the DAVF recurred in the left IPS, and again in the left sigmoid sinus (SS) 3 years after the initial treatment in spite of a second TVE. Moreover, the left SS and the left internal jugular vein, which had been previously stenotic, had been occluded. The third TVE resulted in the complete obliteration of the SS DAVF. CS DAVFs may recur at adjacent sinuses even after complete obliteration by TVE. Careful follow-up is necessary to check for the recurrence of DAVFs, especially in cases with venous flow changes, such as sinus occlusion, following endovascular treatment.
authors.affiliation: Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan. thiu-nagasaki@umin.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hiu
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Horie
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashi
authors.forename: Naoki
authors.initials: N
authors.lastname: Kitagawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Morikawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Kawakubo
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tsutsumi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Suyama
authors.forename: Izumi
authors.initials: I
authors.lastname: Nagata