Surgical Treatment of a Dural Arteriovenous Fistula in the Superior Petrosal Sinus of an Elderly Patient With Minimal Suboccipital Craniotomy -Case Report-

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  • KIMURA Toshikazu
    Department of Neurosurgery and Stroke Unit, Kanto Medical Center, NTT EC.
  • SHOJIMA Masaaki
    Department of Endovascular Neurointervention, Jichi Medical University
  • KOIZUMI Tomoyuki
    Department of Neurosurgery and Stroke Unit, Kanto Medical Center, NTT EC.
  • FUKAYA Syunsuke
    Department of Neurosurgery and Stroke Unit, Kanto Medical Center, NTT EC.
  • ICHIKAWA Yasumitsu
    Department of Neurosurgery and Stroke Unit, Kanto Medical Center, NTT EC.
  • MORITA Akio
    Department of Neurosurgery and Stroke Unit, Kanto Medical Center, NTT EC.

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  • —Case Report—

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An 85-year-old woman presented with a dural arteriovenous fistula of the superior petrosal sinus manifesting as venous infarction of the cerebellum. Magnetic resonance imaging and angiography revealed right cerebellar swelling, venous engorgement, and an arteriovenous fistula in the superior petrosal sinus. Our initial attempt to obliterate the lesion through a transvenous endovascular approach failed, so we successfully treated the fistula via surgical interruption of the superior petrosal vein through a small suboccipital craniotomy. Careful examination of the pattern of venous drainage is important to determine surgical indications. This case indicates that minimally invasive open surgery can be effective even in an elderly patient.<br>

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