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Updated: Jun 11, 2026
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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Multiple dural arteriovenous fistulas. Radiologic progression and endovascular cure. Case report
1Department of Neuroradiology, Royal Perth Hospital, Wellington Street; Perth, Western Australia - tonygoddard@doctors.org.uk.
Summary
This case highlights a rare dural arteriovenous fistula (DAVF) that spontaneously resolved, then recurred. It suggests DAVFs and sinus occlusion may stem from a common pro-thrombotic state, emphasizing careful follow-up.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Dural arteriovenous fistulas (DAVFs) are typically acquired, rarely presenting de novo.
- Co-existence of DAVFs and dural sinus occlusion is uncommon.
- Spontaneous resolution of DAVFs is rare, especially after diagnostic procedures.
Purpose of the Study:
- To present a unique case of a recurrent DAVF following spontaneous resolution and dural sinus occlusion.
- To explore the potential relationship between DAVFs, dural sinus occlusion, and underlying pro-thrombotic states.
- To emphasize the importance of vigilant follow-up for potential DAVF recurrence.
Main Methods:
- Case report of a 71-year-old woman with a complex DAVF.
- Diagnostic arteriography, Magnetic Resonance Angiography (MRA), and catheter angiography.
- Endovascular treatment including particle/alcohol embolization and transvenous coil occlusion.
Main Results:
- Initial right-sided DAVF resolved spontaneously post-arteriography.
- Development of asymptomatic left transverse sinus occlusion.
- Recurrence of a complex type IV left-sided DAVF with extensive cortical venous drainage five years later.
- Successful endovascular cure with immediate symptom resolution.
Conclusions:
- DAVFs and dural sinus occlusion can co-exist, potentially arising from a shared pro-thrombotic condition with secondary angiogenesis.
- Apparent resolution of DAVFs does not preclude recurrence, necessitating long-term monitoring.
- Recognizing symptom changes is crucial for timely intervention in recurrent DAVF cases.
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