De Novo Dural Arteriovenous Fistula Formation Following Asymptomatic Sinus Thrombosis: A Case Report and Review of the Literature

Cerebral venous sinus thrombosis (CVST) has been suggested to play an important role in the pathogenesis of dural arteriovenous fistular (DAVF) formation but studies supporting a causal relationship are rare. We report a 15-year-old male who developed a brief syncopal episode that was felt to be secondary to dehydration. A non-contrast computerized tomography (CT) scan of the head showed hyperdensities of the posterior superior sagittal and bilateral transverse sinuses. Magnetic resonance venogram confirmed the presence of diffuse CVST without cerebral edema, infarction or hemorrhage. Dural sinuses were partially recanalized after a six-week anticoagulation treatment. At 14 months patient was found with a left sided DAVF that was embolized successfully without complications. The presence of asymptomatic, minimally symptomatic or partially treated CVST may be implicated in the pathogenesis of DAVF. doi: http://dx.doi.org/10.4021/jnr195w