Dural arteriovenous fistula (DAVF) after venous sinus stent (VSS) for presumed idiopathic intracranial hypertension (IIH): A case report and literature review

Fatma Shakarchi, MD, MSc; Avery Zhou, MA; Tuan Anh Nguyen, PhD; Saif Aldeen Alryalat, MD; Osama Al Deyabat, MD; Fernando Ahumada, MD; Peter Mortensen, MD; Orlando Diaz, MD; Andrew G. Lee, MD

Radiology Case Reports (Jan 2025)

Dural arteriovenous fistula (DAVF) after venous sinus stent (VSS) for presumed idiopathic intracranial hypertension (IIH): A case report and literature review

Fatma Shakarchi, MD, MSc,
Avery Zhou, MA,
Tuan Anh Nguyen, PhD,
Saif Aldeen Alryalat, MD,
Osama Al Deyabat, MD,
Fernando Ahumada, MD,
Peter Mortensen, MD,
Orlando Diaz, MD,
Andrew G. Lee, MD

Affiliations

Fatma Shakarchi, MD, MSc: Climate Centre, International Red Cross Red Crescent Movement, Geneva, Switzerland; Health and Natural Sciences, Space Generation Advisory Council, Vienna, Austria
Avery Zhou, MA: University of Nevada, Las Vegas School of Medicine, Las Vegas, NV, USA
Tuan Anh Nguyen, PhD: Tri-Institutional MD-PhD Program, Weill Cornell/Rockefeller/Sloan-Kettering, New York, NY, USA
Saif Aldeen Alryalat, MD: Department of Ophthalmology, Houston Methodist Hospital, Houston, TX, USA
Osama Al Deyabat, MD: Department of Ophthalmology, Houston Methodist Hospital, Houston, TX, USA
Fernando Ahumada, MD: Department of Neuroradiology, Houston Methodist Hospital, Houston, TX, USA
Peter Mortensen, MD: Department of Ophthalmology, Houston Methodist Hospital, Houston, TX, USA
Orlando Diaz, MD: Department of Neuroradiology, Houston Methodist Hospital, Houston, TX, USA
Andrew G. Lee, MD: Department of Ophthalmology, Houston Methodist Hospital, Houston, TX, USA; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA; Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA; University of Texas MD Anderson Cancer Center, Houston, TX, USA; Texas A&M College of Medicine, TX, USA; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA; Corresponding author.

Journal volume & issue: Vol. 20, no. 1
pp. 817 – 822

Abstract

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Dural arteriovenous fistulas (DAVFs) are rare but significant intracranial vascular malformations that are usually idiopathic and can lead to severe complications like venous hypertension and intracranial hemorrhage. We present 2 cases of DAVF occurring after venous sinus stenting (VSS) for presumed idiopathic intracranial hypertension (IIH) in a 51-year-old and a 52-year-old female. In both patients, Cognard type 1 DAVF was detected by Catheter angiography and successfully obliterated with Onyx™ embolization. These cases suggest that VSS may either unmask pre-existing DAVFs by altering intracranial pressure dynamics or induce new fistula formation by angiogenic factors or stent-induced hemodynamic changes. Clinicians should maintain an index of suspicion for DAVF in patients with persistent symptoms post-VSS and catheter angiography might be needed to detect the DAVFs.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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