[Intraventricular hemorrhage after dural fistula embolization]

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Vascular Neurology

Background:

• Dural arteriovenous fistulas (dAVFs) are abnormal connections between dural arteries and veins.
• Endovascular embolization is a primary treatment for dAVFs when intervention is necessary.
• This case highlights a rare complication following this established procedure.

Observation:

• A 59-year-old woman with a Cognard Type IV dAVF underwent successful transarterial embolization.
• The patient developed intraventricular hemorrhage and signs of increased intracranial pressure post-procedure.
• Cerebral oximetry remained stable throughout the perioperative period.

Findings:

• Successful endovascular obliteration of the dAVF was confirmed intraoperatively.
• Postoperative intraventricular hemorrhage led to significant complications including the need for a ventricular drain and ICU admission.
• Despite complications, the patient recovered without neurological deficits.

Implications:

• Intraventricular hemorrhage is a potential serious complication of endovascular dAVF treatment.
• Vigilant postoperative surveillance is essential for prompt diagnosis and management.
• Early intervention following hemorrhage can lead to favorable patient outcomes.