Postnatal delayed exacerbation of dural sinus malformation associated with brainstem cavernous malformations: A case...

Area of Science:

• Neurology
• Pediatric Vascular Malformations
• Medical Imaging

Background:

• Dural sinus malformation (DSM) is a rare pediatric vascular malformation.
• The pathophysiology of DSM remains poorly understood due to its rarity.

Observation:

• A male fetus diagnosed with DSM at 26 weeks gestation via ultrasonography.
• The DSM initially regressed in utero but a shunt rapidly developed postnatally.
• The neonate also developed a de novo brainstem cavernous malformation (CM).

Findings:

• Postnatal shunt development in DSM led to aggravated venous hypertension.
• Aggravated venous hypertension contributed to rapid growth of the brainstem CM.
• Multiple endovascular embolizations successfully treated the shunts and stabilized the CM.

Implications:

• This case suggests a potential metameric origin for both DSM and CM.
• Aberrant cases like this enhance understanding of dural sinus malformation pathophysiology.
• The findings highlight the importance of monitoring for delayed shunt development and associated malformations.