You are here

Article Text

Article menu
Download PDFPDF
Neurological picture
Mixed pial-dural fistula development after ventricular shunting
  1. Yince Loh1,2,
  2. David Newell2
  1. 1Interventional Neuroradiology and Neurocritical Care Services, Madigan Army Medical Center, Tacoma, Washington, USA
  2. 2Cerebrovascular Center, Swedish Neuroscience Institute, Seattle, Washington, USA
  1. Correspondence to Dr Yince Loh, Interventional Neuroradiology and Neurocritical Care Services, Madigan Army Medical Center, Building 9040, Fitzsimmons Drive, Tacoma, WA 98431, USA; yincer{at}yahoo.com

https://doi.org/10.1136/jnnp-2014-307775

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Case report

    A 36-year-old male was first diagnosed with increased intracranial pressure following persistent headaches 3 years prior to presentation to our centre. A lumbar puncture had revealed elevated opening pressure, and he underwent ventriculo-peritoneal shunting for pseudotumor cerebri.

    He presented to our centre due to decreased vision. An MRI was suspicious for a superior sagittal sinus (SSS) dural arteriovenous fistula (dAVF), and confirmed by MRA. He underwent catheter angiography, confirming the dAVF but also a separate mixed pial-dural arteriovenous fistula (p-dAVF) at the catheter (figure 1), which used the diseased SSS segment for outflow. Since transvenous occlusion of this segment was a planned part of his endovascular therapy, the p-dAVF was surgically disconnected first, to avoid p-dAVF outflow occlusion.

    Figure 1

    Lateral projection angiography before and after resection of the mixed pial-dural arteriovenous fistula (p-dAVF). Digital subtraction (A) and unsubtracted (B) injection of the right internal carotid artery demonstrates …

    View Full Text

    Footnotes

    • Contributors Both authors were involved in the manuscript design, data collection, analysis, manuscript drafting and final proofing.

    • Competing interests The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Army, the Department of Defense or the US Government.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.