Non-communicating hydrocephalus caused by dural arteriovenous malformation

Area of Science:

• Neurology
• Pediatric Neurosurgery
• Vascular Malformations

Background:

• Dural arteriovenous malformations (dAVMs) are abnormal connections between dural arteries and veins.
• Congenital hydrocephalus can result from various structural abnormalities in the brain's ventricular system.
• Enlargement of cerebral venous sinuses can obstruct cerebrospinal fluid (CSF) pathways.

Observation:

• A female infant presented with non-communicating hydrocephalus.
• The hydrocephalus was attributed to an enormously dilated straight sinus and posterior sagittal sinus.
• These dilated sinuses drained a torcular dural arteriovenous malformation.

Findings:

• Ventriculography demonstrated complete obstruction at the junction of the aqueduct and fourth ventricle.
• Dilated sinuses caused cephaloventral displacement of the ventricular system.
• The dural arteriovenous malformation was successfully embolized after ventriculoperitoneal shunt placement.

Implications:

• This case highlights a rare cause of congenital hydrocephalus due to venous sinus abnormalities.
• Effective management requires a combined approach of CSF diversion and vascular intervention.
• Understanding venous sinus anatomy is crucial in diagnosing and treating pediatric hydrocephalus and vascular malformations.