title: Development of Dural Arteriovenous Fistulas After Cerebral Venous Sinus Thrombosis.
abstract: A 57-year-old man presented with papilledema due to partially recanalized dural sinus thrombosis and was treated with anticoagulation and acetazolamide. One year after treatment and resolution of his symptoms, he had an increase in his optic disc edema accompanied by headaches. Subsequent neuroimaging indicated development of arteriovenous fistulas resulting in cortical and deep venous reflux. Given the high risk of mortality from intracranial hemorrhage, the patient underwent urgent treatment with a liquid embolic agent, which resulted in the resolution of his optic disc edema. Our case is unique in that recurrence of bilateral optic disc edema led to discovery of the rare complication of dural arteriovenous fistulas developing after dural sinus thrombosis. Ongoing monitoring of patients after cerebral venous sinus thrombosis is, therefore, important.
authors.affiliation: Department of Ophthalmology and Vision Science (JAM, EM), University of Toronto, Toronto, Ontario, Canada; Division of Neuroradiology (SD, VMP), Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; and Division of Neurosurgery (VMP), Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Micieli
authors.forename: Sheldon
authors.initials: S
authors.lastname: Derkatch
authors.forename: Vitor M
authors.initials: VM
authors.lastname: Pereira
authors.forename: Edward A
authors.initials: EA
authors.lastname: Margolin
mesh_terms: D000086:Acetazolamide / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003287:Contrast Media / Q000008:administration & dosage; D004338:Drug Combinations; D004621:Embolization, Therapeutic; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010211:Papilledema / Q000188:drug therapy / Q000209:etiology; D011145:Polyvinyls / Q000008:administration & dosage; D012008:Recurrence; D012851:Sinus Thrombosis, Intracranial / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D013635:Tantalum / Q000008:administration & dosage; D041623:Tomography, Optical Coherence
chemical_list: D000925:Anticoagulants; D002257:Carbonic Anhydrase Inhibitors; D003287:Contrast Media; D004338:Drug Combinations; C558446:Onyx 18; D011145:Polyvinyls; D013635:Tantalum; D000086:Acetazolamide