Abstract
A 67-year-old man presented with tinnitus in his right ear, which had been present for several months. His medical history included arterial hypertension and diabetes mellitus type II, which were not concerning. He had observed that if he pressed on a particular spot on the mastoid behind his right ear, the tinnitus intensity decreased. Transarterial embolization, which partially reduced an arteriovenous shunt, successfully reduced the tinnitus. A self-expanding stent was implanted in the right transverse and sigmoid sinus. Over the following weeks, the tinnitus disappeared. Follow-up DSA examinations confirmed the obliteration of the dural arteriovenous fistula. The main topic of this chapter is the treatment of low-grade transverse and sigmoid sinus-dural arteriovenous fistulas with stent-implantation into the venous sinus.
Similar content being viewed by others
References
Aguilar-Pérez M, Martinez-Moreno R, Kurre W, Wendl C, Bäzner H, Ganslandt O, Unsöld R, Henkes H. Endovascular treatment of idiopathic intracranial hypertension: retrospective analysis of immediate and long-term results in 51 patients. Neuroradiology. 2017 Mar;59(3):277–87. https://doi.org/10.1007/s00234-017-1783-5.
Buell TJ, Raper DM, Ding D, Chen CJ, Liu KC. Development of an intracranial dural arteriovenous fistula after venous sinus stenting for idiopathic intracranial hypertension. BMJ Case Rep. 2017;2017:bcr2017013282. https://doi.org/10.1136/bcr-2017-013282.
Chen CJ, Lee CC, Ding D, Starke RM, Chivukula S, Yen CP, Moosa S, Xu Z, Pan DH, Sheehan JP. Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review. J Neurosurg. 2015 Feb;122(2):353–62. https://doi.org/10.3171/2014.10.JNS14871.
Choi BJ, Lee TH, Kim CW, Choi CH. Reconstructive treatment using a stent-graft for a dural arteriovenous fistula of the transverse sinus in the case of hypoplasia of the contralateral venous sinuses: technical case report. Neurosurgery. 2009;65(5):E994–6; discussion E996. https://doi.org/10.1227/01.NEU.0000351772.45417.92.
Cognard C, Gobin YP, Pierot L, Bailly AL, Houdart E, Casasco A, Chiras J, Merland JJ. Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Radiology. 1995;194(3):671–80. https://doi.org/10.1148/radiology.194.3.7862961.
Ding D. Role of venous stenting in the management of inoperable intracranial arteriovenous malformations. Br J Neurosurg. 2013;27(6):850–1. https://doi.org/10.3109/02688697.2013.835382.
Ghobrial GM, Marchan E, Nair AK, Dumont AS, Tjoumakaris SI, Gonzalez LF, Rosenwasser RH, Jabbour P. Dural arteriovenous fistulas: a review of the literature and a presentation of a single institution’s experience. World Neurosurg. 2013;80(1–2):94–102. https://doi.org/10.1016/j.wneu.2012.01.053.
Kirsch M, Liebig T, Kühne D, Henkes H. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients. Neuroradiology. 2009;51(7):477–83. https://doi.org/10.1007/s00234-009-0524-9.
Levitt MR, Albuquerque FC, Gross BA, Moon K, Jadhav AP, Ducruet AF, Crowley RW. Venous sinus stenting in patients without idiopathic intracranial hypertension. J Neurointerv Surg. 2017;9(5):512–5. https://doi.org/10.1136/neurintsurg-2016-012405.
Levrier O, Métellus P, Fuentes S, Manera L, Dufour H, Donnet A, Grisoli F, Bartoli JM, Girard N. Use of a self-expanding stent with balloon angioplasty in the treatment of dural arteriovenous fistulas involving the transverse and/or sigmoid sinus: functional and neuroimaging-based outcome in 10 patients. J Neurosurg. 2006;104(2):254–63. https://doi.org/10.3171/jns.2006.104.2.254.
Li K, Ren M, Meng R, Wang F, Ji X. Dural arteriovenous fistula formation complicated cerebral venous sinus stenosis after venous sinus stenting. World Neurosurg. 2018;120:400–2. https://doi.org/10.1016/j.wneu.2018.08.230.
Liebig T, Henkes H, Brew S, Miloslavski E, Kirsch M, Kühne D. Reconstructive treatment of dural arteriovenous fistulas of the transverse and sigmoid sinus: transvenous angioplasty and stent deployment. Neuroradiology. 2005;47(7):543–51. https://doi.org/10.1007/s00234-005-1377-5.
Lin YH, Lee CW, Liu HM. Clinical outcomes of adjunct sinus stenting in dural arteriovenous fistulas: Role of flow restoration in steno-occlusion and cortical venous reflux. Clin Neuroradiol. 2021; https://doi.org/10.1007/s00062-021-01031-3.
Murakami T, Toyota S, Suematsu T, Wada Y, Nakagawa K, Shimizu T, Mori K, Taki T. Balloon anchoring to traverse the sigmoid sinus for delivery of large-caliber venous stents: a technical note. Interv Neuroradiol. 2021;27(5):712–5. https://doi.org/10.1177/1591019921996885.
Murphy KJ, Gailloud P, Venbrux A, Diamond H, Hanley D, Rigamonti D. Endovascular treatment of a grade IV transverse sinus dural arteriovenous fistula by sinus recanalization, angioplasty, and stent placement: technical case report. Neurosurgery. 2000;46(2):497–500.; discussion 500-1. https://doi.org/10.1097/00006123-200002000-00048.
Pan DH, Chung WY, Guo WY, Wu HM, Liu KD, Shiau CY, Wang LW. Stereotactic radiosurgery for the treatment of dural arteriovenous fistulas involving the transverse-sigmoid sinus. J Neurosurg. 2002;96(5):823–9. https://doi.org/10.3171/jns.2002.96.5.0823.
Renieri L, Michelozzi C, Brinjikji W, Darcout J, Guenego A, Vukasinovic I, Tall P, Bonneville F, Januel AC, Cognard C. PTA stent of dural sinuses in brain DAVF: a report of 4 cases. Clin Neuroradiol. 2019;29(2):331–9. https://doi.org/10.1007/s00062-017-0652-2.
Takemoto K, Higashi T, Sakamoto S, Inoue T. Successful sinus restoration for transverse-sigmoid sinus dural arteriovenous fistula complicated by multiple venous sinus occlusions: the usefulness of preoperative computed tomography venography. Surg Neurol Int. 2015;18(6):137. https://doi.org/10.4103/2152-7806.163176.
Tetsuo Y, Matsumoto H, Nishiyama H, Takemoto H, Nakao N. [Percutaneous transluminal sinus stenting for sigmoid sinus stenosis associated with transverse-sigmoid sinus dural arteriovenous fistula: a case report]. No Shinkei Geka. 2018;46(4):325–332. Japanese. https://doi.org/10.11477/mf.1436203726.
Wanke I, Rüfenacht DA. The dural AV fistula (DAVF), the most frequent acquired vascular malformation of the central nervous system (CNS). Clin Neuroradiol. 2015;25(Suppl 2):325–32. https://doi.org/10.1007/s00062-015-0449-0.
Weber W, Kis B, Esser J, Berlin P, Kühne D. Endovascular treatment of a dural arteriovenous fistula of the transverse sinus by recanalisation, angioplasty and stent deployment. A case report and follow-up. Interv Neuroradiol. 2003;9(1):65–9. https://doi.org/10.1177/159101990300900111.
Yeh PS, Wu TC, Tzeng WS, Lin HJ. Endovascular angioplasty and stent placement in venous hypertension related to dural arteriovenous fistulas and venous sinus thrombosis. Clin Neurol Neurosurg. 2010;112(2):167–71. https://doi.org/10.1016/j.clineuro.2009.10.018.
Zhang K, Gao BL, Zhu LF, Xue JY, Yang BW, Li TX. Endovascular recanalization of occluded dural sinus inpatient with dural arteriovenous fistulas: case report and literature review. World Neurosurg. 2018;114:269–73. https://doi.org/10.1016/j.wneu.2018.03.140.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this entry
Cite this entry
Sirakov, A., Hellstern, V., Khanafer, A., Bäzner, H., Henkes, H. (2022). Transverse and Sigmoid Sinus Dural Arteriovenous Fistula Causing Tinnitus: Treatment with Transarterial Embolization and Stent Implantation into the Sigmoid Sinus; Early Tinnitus Cessation and Arteriovenous Shunt Occlusion During Long-Term Follow-Up. In: Henkes, H., Lylyk, P., Ganslandt, O., Cohen, J.E. (eds) The Arteriovenous Malformations and Fistulas Casebook. Springer, Cham. https://doi.org/10.1007/978-3-030-51200-2_37-1
Download citation
DOI: https://doi.org/10.1007/978-3-030-51200-2_37-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-51200-2
Online ISBN: 978-3-030-51200-2
eBook Packages: Springer Reference MedicineReference Module Medicine