Dural arteriovenous fistula formation following bilateral middle meningeal artery embolization for the treatment of a chronic subdural hematoma: a case report

• Published in: Acta neurochirurgica Vol. 163; no. 4; pp. 1069 - 1073
• Main Authors: Shotar, Eimad, Premat, Kevin, Barberis, Eric, Talbi, Atika, Lenck, Stéphanie, Cohen, Clara, Degos, Vincent, Sourour, Nader-Antoine, Mathon, Bertrand, Clarençon, Frédéric
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.04.2021; Springer Nature B.V
• Subjects: Angiography; Arteries; Blood; Brain; Case Report - Vascular Neurosurgery - Other; Case reports; Dura mater; Embolization; Fistula; Fistulae; Hematoma; Hypoxia; Interventional Radiology; Medicine; Medicine & Public Health; Meninges; Microparticles; Minimally Invasive Surgery; Neurology; Neuroradiology; Neurosurgery; Superior sagittal sinus; Surgical Orthopedics; Vascular Neurosurgery – Other; Embolization; Chronic subdural hematoma; Dural arteriovenous fistula; Middle meningeal artery
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-020-04696-w

Here is reported a case of dural arteriovenous fistula (DAVF) formation following middle meningeal artery (MMA) embolization. A 64-year-old male patient was operated for a bilateral CSDH by burr-hole craniostomy. Prophylactic post-operative MMA embolization was performed with 300–500-μm calibrated microparticles. The patient was admitted 3 months later for a left CSDH recurrence. Digital subtraction angiography demonstrated formation of a superior sagittal sinus DAVF fed by both superficial temporal arteries. This case highlights the possible role of local tissue hypoxia as a significant component of DAVF pathogenesis. Moreover, it has potential implications for MMA embolization as a management strategy for CSDH.