Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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Navigation guided small craniectomy and direct cannulation of pure isolated sigmoid sinus for treatment of dural arteriovenous fistula

  • Jun Ho Shim (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Gi Yong Yun (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Jae-Min Ann (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Jong-Hyun Park (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Hyuk-Jin Oh (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Jai-Joon Shim (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Seok Mann Yoon (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
  • Received : 2023.05.30
  • Accepted : 2023.07.25
  • Published : 2024.03.31
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Abstract

Dural arteriovenous fistula (DAVF) is a rare condition affecting approximately 1.5% of 1,000,000 individuals annually. It frequently occurs in the transsigmoid and cavernous sinuses. An isolated sigmoid sinus is extremely rare and is treated by performing transfemoral transvenous embolization along the opposite transverse sinus. A 69-year-old woman presented with asymptomatic Borden type III/Cognard type III DAVF involving an isolated sigmoid sinus. She underwent a staged operation in which a navigation system was used to expose the sigmoid sinus in the operating room before transferring the patient to the angio suite for transvenous embolization. Various modalities have been used to treat DAVF, including surgical disconnection, transarterial embolization, transvenous embolization, and stereotactic radiosurgery. However, treating DAVF cases where the affected sinus is isolated can be challenging because an easily accessible surgical route may not be available. In this case, direct sinus cannulation and transvenous embolization were the most effective treatments.

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References

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