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Case report
Posterior fossa dural arteriovenous fistula presenting clinically as a carotid–cavernous fistula treated by a direct access cavernous sinus approach
  1. Ai Peng Tan,
  2. Manish Taneja,
  3. Francis Hui
  1. Department of Neuroradiology, National Neuroscience Institute, Singapore
  1. Correspondence to Dr Ai Peng Tan, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433;tan_ai_peng{at}hotmail.com

Abstract

Dural arteriovenous fistulas (dAVFs) represent approximately 10–15% of all cerebral vascular malformations. Although dAVFs can occur anywhere in the brain, they occur most frequently in the cavernous and transverse-sigmoid sinuses. Posterior fossa dAVFs presenting clinically as carotid–cavernous fistulae (CCF) are rarely encountered in clinical practice. We discuss and illustrate an unusual case of a left posterior fossa dAVF that presented clinically with chemosis and early visual impairment, similar to that of CCF. This was subsequently treated by a direct access cavernous sinus approach. We describe the technique used to access the cavernous sinus directly in cases where conventional transvenous and transarterial routes have been exhausted.

  • Fistula
  • Posterior fossa
  • Technique
  • Vascular Malformation

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