Korean J Cerebrovasc Surg.  2007 Jun;9(2):143-147.

Treatment of Superior Sagittal Sinus Dural Arteriovenous Fistula

• Kim TY
• Lee HJ
• Yi JS
• Yang JH
• Lee IW

Abstract

OBJECTIVE
Dural arteriovenous fistulas (dAVFs) at the superior sagittal sinus (SSS) are very rare. Endovascular treatment alone often fails to eliminate the fistula because of the midline location of the SSS, the eloquent venous drainage and the multiple bilateral arterial feeders. Surgical extirpation of dAVFs is not recommended in all cases because of the considerable risks involved. We report here on a case of dAVF at the SSS with patent sinus drainage and retrograde leptomeningeal venous drainage, and this was selectively disconnected using an aneurysmal clip under intraoperative Doppler monitoring. The neurological symptoms vanished during the 2 years of follow-up, and no further progression of the dAVF has been found. The methods of converting aggressive dAVFs to benign forms are relatively safe and simple. Therefore, this simple and effective method could be recommended for older aged patients with high intraoperative risk.

Keyword

Superior sagittal sinus; Dural arteriovenous fistula; Intraoperative Doppler

MeSH Terms

Aneurysm
Central Nervous System Vascular Malformations*
Drainage
Fistula
Follow-Up Studies
Humans
Superior Sagittal Sinus*