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Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
Pediatric traumatic dural arteriovenous fistula
Michael Vassilyadi1, Naveen Mehrotra, Mohammed F Shamji
1Division of Neurosurgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Summary
Traumatic pediatric dural arteriovenous fistulas are rare. Surgical intervention may be necessary after failed endovascular treatment, offering a good long-term outcome for children.
Area of Science:
- Pediatric neurosurgery
- Vascular neurology
- Traumatic brain injury management
Background:
- Dural arteriovenous fistulas (dAVFs) are rare in children, often resulting from trauma.
- Management requires careful assessment of presentation, neurological status, and anatomy.
- Surgery may be needed if endovascular treatment fails.
Observation:
- A 12-year-old boy developed a dural arteriovenous fistula after a bicycle accident.
- The fistula involved the middle meningeal artery and a dural vein draining into the sigmoid sinus.
- Initial symptoms included a temporal bruit.
Findings:
- Endovascular treatment with embolization and coiling was unsuccessful.
- Surgical excision of the fistula via craniectomy was performed.
- The patient recovered well with no neurological deficits or recurrence after six years.
Implications:
- Traumatic dural arteriovenous fistulas can occur in children, potentially from minor arterial injury.
- Failure of endovascular techniques may necessitate surgical management.
- Surgical treatment can lead to favorable long-term outcomes in pediatric dAVFs.
