Suboccipital, Supracerebellar, Infratentorial Approach for Microsurgical Clipping of a Ruptured Tentorial, Straight Sinus Type Dural Arteriovenous Fistula

Thomas Tyler Patterson, Matthew Webb, David J. Wallace, Jean Louis Caron, Justin R. Mascitelli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Dural arteriovenous fistulas (dAVFs) can often be successfully treated with endovascular embolization; however, surgery is occasionally still required. Case Description: Herein, we discuss a 65-year-old male patient who presented with a Hunt-Hess IV subarachnoid hemorrhage, intraventricular hemorrhage, and cerebellar intracranial hemorrhage secondary to a ruptured Borden type III tentorial (straight sinus) dAVF. Angiography revealed supply from the left occipital and posterior meningeal arteries and direct drainage into the cerebellar cortical veins with venous aneurysms in both cerebellar hemispheres. Both transarterial and transvenous embolization were attempted, without success. Therefore, the patient was taken to the operating room for clip ligation of the dAVF. The operative video demonstrates a bilateral suboccipital craniotomy and supracerebellar infratentorial approach for surgical clipping of the dAVF. Conclusions: The case and operative video provide a valuable addition to surgical literature in an era where surgical management of dAVFs has become relatively rare.

Original languageEnglish (US)
Pages (from-to)131-135
Number of pages5
JournalWorld neurosurgery
Volume142
DOIs
StatePublished - Oct 2020

Keywords

  • Dural arteriovenous fistula
  • Posterior fossa dAVF
  • Resection of dural AVF
  • Ruptured dAVF
  • Suboccipital craniotomy
  • dAVF

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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