Case report: Transvenous coil embolization of a high-grade Galenic dural arteriovenous fistula
IntroductionGalenic dural arteriovenous fistulas (dAVFs) are a rare form of dAVF and rarely described in the literature. Their distinct location requires different surgical approaches than dAVFs occurring at the nearby sites of the straight sinus and torcular Herophili, and their high risk of hemorr...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-04-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1128563/full |
| _version_ | 1797849220693098496 |
|---|---|
| author | Christiana M. Cornea Nathan Quig Edward Yap Sten Y. Solander |
| author_facet | Christiana M. Cornea Nathan Quig Edward Yap Sten Y. Solander |
| author_sort | Christiana M. Cornea |
| collection | DOAJ |
| description | IntroductionGalenic dural arteriovenous fistulas (dAVFs) are a rare form of dAVF and rarely described in the literature. Their distinct location requires different surgical approaches than dAVFs occurring at the nearby sites of the straight sinus and torcular Herophili, and their high risk of hemorrhage makes these dAVFs very challenging to approach surgically. In this report, we present a unique case of Galenic dAVF.Case descriptionThe patient is a 54-year-old female who presented with a 2-year history of progressive headaches, cognitive decline, and papilledema. A cerebral angiogram demonstrated a complex dAVF to the vein of Galen (VoG). She underwent transarterial embolization with Onyx-18 which resulted in minimal reduction in arterial venous shunting. She subsequently underwent a successful transvenous coil embolization resulting in complete occlusion of dAVF. The patient’s postoperative course was complicated by interventricular hemorrhage; however, she had a remarkable clinical recovery with resolution of headaches and improvement in cognitive function. A follow-up angiogram completed 6 months post-embolization demonstrated very mild residual shunting.ConclusionIn the unique case presented here, we demonstrate the efficacy of transvenous embolization via an occluded straight sinus as an alternative therapeutic option to eliminate cortical venous reflux. |
| first_indexed | 2024-04-09T18:40:21Z |
| format | Article |
| id | doaj.art-201a8f88883b45c9aec31a28835d0e3a |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T18:40:21Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-201a8f88883b45c9aec31a28835d0e3a2023-04-11T05:29:29ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11285631128563Case report: Transvenous coil embolization of a high-grade Galenic dural arteriovenous fistulaChristiana M. Cornea0Nathan Quig1Edward Yap2Sten Y. Solander3University of North Carolina School of Medicine, Chapel Hill, NC, United StatesDepartment of Neurosurgery, University of North Carolina Hospitals, Chapel Hill, NC, United StatesDepartment of Neurosurgery, University of North Carolina Hospitals, Chapel Hill, NC, United StatesDepartment of Radiology, University of North Carolina Hospitals, Chapel Hill, NC, United StatesIntroductionGalenic dural arteriovenous fistulas (dAVFs) are a rare form of dAVF and rarely described in the literature. Their distinct location requires different surgical approaches than dAVFs occurring at the nearby sites of the straight sinus and torcular Herophili, and their high risk of hemorrhage makes these dAVFs very challenging to approach surgically. In this report, we present a unique case of Galenic dAVF.Case descriptionThe patient is a 54-year-old female who presented with a 2-year history of progressive headaches, cognitive decline, and papilledema. A cerebral angiogram demonstrated a complex dAVF to the vein of Galen (VoG). She underwent transarterial embolization with Onyx-18 which resulted in minimal reduction in arterial venous shunting. She subsequently underwent a successful transvenous coil embolization resulting in complete occlusion of dAVF. The patient’s postoperative course was complicated by interventricular hemorrhage; however, she had a remarkable clinical recovery with resolution of headaches and improvement in cognitive function. A follow-up angiogram completed 6 months post-embolization demonstrated very mild residual shunting.ConclusionIn the unique case presented here, we demonstrate the efficacy of transvenous embolization via an occluded straight sinus as an alternative therapeutic option to eliminate cortical venous reflux.https://www.frontiersin.org/articles/10.3389/fneur.2023.1128563/fulldural arteriovenous fistulavein of Galentransvenous embolizationoccluded straight sinusendovascular coiling |
| spellingShingle | Christiana M. Cornea Nathan Quig Edward Yap Sten Y. Solander Case report: Transvenous coil embolization of a high-grade Galenic dural arteriovenous fistula Frontiers in Neurology dural arteriovenous fistula vein of Galen transvenous embolization occluded straight sinus endovascular coiling |
| title | Case report: Transvenous coil embolization of a high-grade Galenic dural arteriovenous fistula |
| title_full | Case report: Transvenous coil embolization of a high-grade Galenic dural arteriovenous fistula |
| title_fullStr | Case report: Transvenous coil embolization of a high-grade Galenic dural arteriovenous fistula |
| title_full_unstemmed | Case report: Transvenous coil embolization of a high-grade Galenic dural arteriovenous fistula |
| title_short | Case report: Transvenous coil embolization of a high-grade Galenic dural arteriovenous fistula |
| title_sort | case report transvenous coil embolization of a high grade galenic dural arteriovenous fistula |
| topic | dural arteriovenous fistula vein of Galen transvenous embolization occluded straight sinus endovascular coiling |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1128563/full |
| work_keys_str_mv | AT christianamcornea casereporttransvenouscoilembolizationofahighgradegalenicduralarteriovenousfistula AT nathanquig casereporttransvenouscoilembolizationofahighgradegalenicduralarteriovenousfistula AT edwardyap casereporttransvenouscoilembolizationofahighgradegalenicduralarteriovenousfistula AT stenysolander casereporttransvenouscoilembolizationofahighgradegalenicduralarteriovenousfistula |