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

Shotar, Eimad; Premat, Kevin; Barberis, Eric; Talbi, Atika; Lenck, Stéphanie; Cohen, Clara; Degos, Vincent; Sourour, Nader-Antoine et al. · Acta Neurochir (Wien) · 2021

case_report · Level V

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Abstract

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.

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