Arteriovenous malformation affecting the transverse dural venous sinus--an acquired lesion

Dural arteriovenous malformations of the transverse sinus are relatively well localized to the occipitomastoid regions and occur predominantly in women who are more than 40 years of age. The signs and symptoms, except for pulsatile tinnitus, vary and apparently depend on the presence of impaired venous drainage, which may produce increased intracranial pressure, papilledema, and transient or persistent neurologic deficits. Eight of the 14 patients described had occlusion of one or both transverse or sigmoid sinuses. Two patients had angiographic demonstration of sigmoid or transverse sinus occlusion (one 1 year and the other 4 years) before the development of an arteriovenous malformation in the appropriate sinus. Dural sinus occlusion may precede the development of a dural arteriovenous malformation, and the pathogenesis may be partial recanalization of a thrombus.