Sensorineural Hearing Loss After Transvenous Embolization of a Transverse-Sigmoid Sinus Dural Arteriovenous Fistula

We report a case of sensorineural hearing loss following transvenous embolization (TVE) of a transverse-sigmoid sinus dural arteriovenous fistula (TS-DAVF) with cortical venous reflux from an isolated sinus. A 64-year-old woman was transferred to our hospital on an emergency basis due to slurred speech and suspected stroke. Magnetic resonance imaging (MRI) revealed TS-DAVF with cortical venous reflux on the left side. We diagnosed her with TS-DAVF and Cognard type IIa+b, and performed TVE via an occluded sigmoid sinus. Posttreatment angiography confirmed the absence of an arteriovenous shunt. On the day after treatment, she experienced dizziness and nausea upon movement, and was diagnosed with inner ear vertigo, for which medical treatment was initiated. Postoperative MRI showed no ischemic lesions on diffusion-weighted imaging and revealed shrinkage of dilated cortical veins on T2-weighted imaging. However, on the seventh postoperative day, she noticed hearing loss on the left side. An otolaryngological examination confirmed sensorineural hearing loss, and she was subsequently treated with steroids. Her hearing impairment gradually improved, and as the hearing loss did not interfere with her daily life, she was discharged on the 12th postoperative day. There are several case reports of sensorineural hearing loss following TVE for TS-DAVF, indicating this is a potential complication that should be considered, especially when there is extensive occlusion of an isolated sinus.