title: A unique type of dural arteriovenous fistula at confluence of sinuses treated with endovascular embolization: a case report.
abstract: Dural arteriovenous fistula (DAVF) is classically defined as abnormal arteriovenous connections located within the dural leaflets. Though the exact etiology is still not clear, they are generally accepted as acquired lesions. However, some DAVFs formed as the congenital disorders are called dural arteriovenous malformations and these lesions with a marked cortical venous reflux are considered to be aggressive and warrant an early intervention. The authors describe a case of 35-year-old man presented with unique type of DAVF. The fistula was located adjacent to the confluence of venous sinuses with multiple feeders. The feeders drained into a large venous pouch just anterior to the confluence which had a bilateral venous drainage. This was associated with multiple cerebellar venous ectasia along the draining cortical vein. It was managed by staged endovascular procedures and complete cure could be achieved. The pathogenesis and technique of embolization of this complex fistula/malformation are also discussed.
authors.affiliation: Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. ; Department of Neurosurgery, G B Pant Hospital, Maulana Azad Medical College, University of Delhi, New Delhi, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Gupta
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyachi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Matsubara
authors.forename: Takashi
authors.initials: T
authors.lastname: Izumi
authors.forename: Takehiro
authors.initials: T
authors.lastname: Naito
authors.forename: Kenichi
authors.initials: K
authors.lastname: Haraguchi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Wakabayashi
keywords: Confluence of sinuses; Cortical reflux; Dural arteriovenous fistula; Embolization; Varix