RT Journal Article
SR Electronic
T1 Pharyngo-tympano-stapedial middle meningeal artery variant supply to a falcotentorial dural arteriovenous fistula
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 1226
OP 1228
DO 10.1136/neurintsurg-2022-018817
VO 14
IS 12
A1 Amanda Baker
A1 Kunal Raygor
A1 M Travis Caton, Jr
A1 Kazim H Narsinh
A1 Eric Smith
A1 Christopher F Dowd
A1 Daniel L Cooke
A1 Randall T Higashida
A1 Matthew R Amans
A1 Adib A Abla
A1 Steven W Hetts
YR 2022
UL http://jnis.bmj.com/content/14/12/1226.abstract
AB The pharyngo-tympano-stapedial middle meningeal artery (PTS-MMA) variant has been described in one case report and never in the setting of arterial supply to a dural arteriovenous fistula, to our knowledge. We report the case of a middle-aged patient with severe, daily headache who presented to our institution for angiography and treatment. CT angiography and MRI demonstrated an enlarged left middle meningeal artery coursing to a large venous varix in the falcotentorial region. Dural arteriovenous fistula was confirmed by subsequent cerebral angiography. Endovascular treatment was performed but without complete obliteration of the fistula. Follow-up angiography demonstrated parasitized arterial supply from a right middle meningeal artery arising from the proximal cervical internal carotid artery coursing through the middle ear consistent with a PTS-MMA variant. The fistula was then treated surgically without recurrence at the 6-month follow-up.