Traumatic Middle Meningeal Arteriovenous Fistula Managed using Coil Embolization: A Case Report

Arteriovenous fistulas (AVFs) involving the middle meningeal artery (MMA) and middle meningeal vein were initially described in 1951. Middle meningeal arteriovenous fistulas (MMAVFs) are rare abnormalities classified as dural AVFs, connecting the MMA to the nearby dural venous sinus or cortical veins. Clinical symptoms of MMAVFs include pulsatile tinnitus, headache, exophthalmos, chemosis, and diplopia. Moreover, MMAVFs pose the risk of catastrophic cerebral hemorrhage. Previous studies have suggested that endovascular embolization using coils or other embolic materials produces acceptable outcomes including symptom relief and bleeding prevention. We present a case of traumatic MMAVF in a 27-year-old male with pulsatile tinnitus. The MMAVF was eliminated via endovascular transarterial embolization using a coil, without any residual symptoms or complications. These results suggest that endovascular embolization may be effective in managing MMAVF.