Toshiya Ishikura, Yuri Sonoda, Yoshitomo Motomura, Kenta Kajiwara, Noriyuki Kaku, Pin Fee Chong, Yuichiro Hirata, Hikaru Kanemasa, Hazumu Nagata, Kenichiro Yamamura, Koichi Arimura, Akira Nakamizo, Yasunari Sakai, Shouichi Ohga
Kyushu University.
Japan
Clinical Neurology and Neurosurgery
Clin Neurol Neurosurg 2024;
DOI: 10.1016/j.clineuro.2024.108540
Abstract
Dural arteriovenous fistula (DAVF) represents a pathological group of intracranial shunts arising from the dural artery to venous sinus and veins. Childhood-onset DAVF is generally considered to be poor in prognosis, whereas only limited information is available for the onset and long-term outcomes. We herein report a Japanese girl with trisomy 21, large ventricular septal defects, and pulmonary vein stenosis, for which a transcatheter stent had been placed after birth. At age 6 years, she developed bacterial meningitis due to S. pneumoniae, leading to the diagnosis of venous sinus thrombosis and multiple intracranial shunts. Cerebral angiography identified multiple shunts arising from the middle meningeal arteries to the superior sagittal sinus and a concurrent reflux to cortical vein. Endovascular embolization successfully occluded the shunts without neurovascular complications over 24 months. This report first demonstrates the favorable outcome of DAVF in a pediatric patient with trisomy 21 after the catheter intervention. For children at a risk for intracranial thrombosis, preemptive neurovascular evaluation and transcatheter intervention provide a chance of early diagnosis of DAVF to improve their survival and neurologic outcome.
Category
Stenosis or Obstruction of Normal Pulmonary Venous Connections
Catheter-mediated Interventions: Efficacy or Lack of Efficacy
Year of Publication: 2024
Age Focus: Pediatric
Article Type: Case Reports or Retrospective Observations in Small Groups of Patients (≤10 patients)
Article Access: Free PDF File or Full Text Article Available Through PubMed or DOI: Yes