A Case of Iatrogenic Middle Meningeal Arteriovenous Fistula That Occurred during Embolization of a Feeding Artery of Dural Arteriovenous Fistula

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  • Kitano Takaya
    Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Matsubara Shunji
    Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Ogawa Yukari
    Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Kinoshita Keita
    Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Takai Hiroki
    Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Hirai Satoshi
    Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Hara Keijirou
    Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Matsushita Nobuhisa
    Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Toi Hiroyuki
    Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Uno Masaaki
    Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan

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Abstract

<p>Objective: A case of iatrogenic dural arteriovenous fistula that occurred during embolization of a feeding artery for transverse sinus (TS) dural arteriovenous fistula is reported.</p><p>Case Presentation: A 66-year-old woman suddenly noted pain of the left temporal region and nausea and was emergently transported to our hospital. CT of the head showed left subcortical hemorrhage, and DSA demonstrated a dural arteriovenous fistula at the left TS. Although embolization of the feeding artery was attempted via the middle meningeal artery (MMA), a middle meningeal arteriovenous fistula (MMAVF) developed as the MMA was damaged by intraoperative balloon inflation. The MMA was immediately embolized together with the fistulous opening using n-butyl-2-cyanoacrylate (NBCA) and coils, and no sequelae were observed postoperatively.</p><p>Conclusion: We experienced dural arteriovenous fistula caused by injury of the feeding artery during endovascular treatment. It must be remembered that iatrogenic arteriovenous fistula is a complication of endovascular treatment that is rare but requires attention.</p>

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