title: A single burr hole approach for direct transverse sinus cannulation for the treatment of a dural arteriovenous fistula.
abstract: A 55-year-old woman with a symptomatic Borden II/Cognard IIa+b transverse sinus dural arteriovenous fistula underwent an attempted percutaneous transvenous embolization which was ultimately not possible given the fistula anatomy. She then underwent a partial percutaneous transarterial embolization but the fistula recurred. Given the failed percutaneous interventions, the patient underwent a combined open surgical/transvenous embolization using neuronavigation and a single burr hole craniectomy. She has remained symptom free for 3 months. This case report illustrates the feasibility of combining minimally invasive open surgical access to allow for direct venous cannulation for endovascular embolization of a dural arteriovenous fistula when traditional percutaneous methods are not an option.
authors.affiliation: Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Caplan
authors.affiliation: Division of Neurointerventional Radiology, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Ian
authors.initials: I
authors.lastname: Kaminsky
authors.affiliation: Division of Neurointerventional Radiology, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gailloud
authors.affiliation: Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Judy
authors.initials: J
authors.lastname: Huang
mesh_terms: D002404:Catheterization / Q000379:methods*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods; D011859:Radiography; D016896:Treatment Outcome
keywords: Angiography; Brain; Coil; Fistula; Navigation