Spontaneous Closure of Transverse Sinus Dural Arteriovenous Fistula

A 60-year-old man presented with transverse sinus dural arteriovenous fistula (AVF) manifesting as sudden onset of headache and nausea, which underwent spontaneous closure 5 years after the onset. Computed tomography on admission revealed small intraventricular hemorrhage in the right lateral ventricle. No intracranial vascular lesion was detected and magnetic resonance angiography was used at yearly follow up. Two years after the first admission, he suffered diplopia and cerebral angiography revealed transverse sinus dural AVF. Right pulsatile tinnitus occurred 4 years after the first admission. The symptoms suddenly disappeared 5 years after the first admission, and follow-up angiography showed disappearance of the dural AVF. The exact mechanism of the spontaneous occlusion of dural AVF remains unknown. This case of spontaneous transverse sinus dural AVF closure occurred without disruption of sinus patency, suggesting that thrombosis of the draining veins into sinuses was not involved.