Acquired dural arteriovenous fistula after cerebellopontine angle meningioma: A case report. Issue 28 (15th July 2022)

• Record Type: Journal Article
• Authors: Park, Jung-Soo; Lee, Jong-Myong
• Is Part Of: Medicine. Volume 101:Issue 28(2022)
• Page Start: e29671
• Publication Date: 2022-07-15
• Subjects: arteriovenous fistula -- bone defects -- craniotomy -- craniectomy; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000029671
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Rationale: Intracranial brain surgeries, including ventriculostomy, burr hole, craniotomy, and craniectomy, are the most common causes of acquired dural arteriovenous fistula (dAVF). Here we report a case of acquired dAVF after a cerebellopontine angle meningioma surgery. Patient concerns: A 51-year-old woman was diagnosed with a 40-mm cerebellopontine angle meningioma. The patient underwent surgery via a retrosigmoid suboccipital approach. A small craniotomy and an additional craniectomy were performed. At 7 months after the surgery, she presented with pulsating tinnitus and headache. Diagnosis: Magnetic resonance imaging and digital subtraction angiography showed a dAVF that was fed by the occipital artery and drained into transverse and sigmoid sinuses. Interventions: We performed Onyx® (Irvine, CA) embolization. Outcomes: The patient's symptoms completely improved. Lessons: Craniectomy defects, partially exposed sinuses, and incomplete cranioplasty might be risk factors for iatrogenic dAVF after a retrosigmoid suboccipital craniotomy or craniectomy. Complete reconstructive cranioplasty is an essential procedure to prevent a direct connection between the venous sinus and the external carotid artery.