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Case Reports
. 2022 May 20:13:216.
doi: 10.25259/SNI_322_2022. eCollection 2022.

A case of cribriform plate dural arteriovenous fistulas with a rare complication after endovascular therapy

Issei Takano  1 , Tomoji Takigawa  1 , Kei Shimmyo  1 , Toru Anazawa  1 , Takahiro Kanaya  1 , Yoshiko Fujii  1 , Yasuhiko Nariai  1 , Yoshiki Sugiura  1 , Ryotaro Suzuki  1 , Masaya Nagaishi  1 , Akio Hyodo  1 , Kensuke Suzuki  1
Affiliations
Case Reports

A case of cribriform plate dural arteriovenous fistulas with a rare complication after endovascular therapy

Issei Takano et al. Surg Neurol Int. .

Abstract

Background: Cribriform plate dural arteriovenous fistulas (dAVFs) are rarely encountered. Here, we report a case of cribriform plate dAVF with a rare complication after endovascular therapy.

Case description: A 60-year-old man presented with severe sudden headache. Head computed tomography showed right subdural hematoma, and magnetic resonance angiography showed dilated bilateral frontal cortical vein. Digital subtraction angiography revealed cribriform plate dAVF fed by the anterior and posterior ethmoidal branches of the bilateral ophthalmic arteries. Transarterial embolization with liquid embolic material was performed and the fistula disappeared. Although magnetic resonance imaging showed the disappearance of the cribriform plate dAVF and subdural hematoma, the patient complained of anosmia after the procedure.

Conclusion: Endovascular embolization is an effective treatment option for treating cribriform plate dAVFs. However, anosmia is a possible complication, and endovascular surgeons should take care of this complication, especially in cribriform plate dAVFs supplied with blood bilaterally.

Keywords: Case report; Endovascular procedures; Ethmoid bone; Hematoma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
(a and b) Head computed tomography and fluid-attenuated inversion recovery magnetic resonance images show a right subdural hematoma (arrow). (c and d) Magnetic resonance angiography showed the bilateral frontal cortical vein (arrow).
Figure 2:
Figure 2:
(a and b) Digital subtraction angiography showed a fistula (arrow) from the ophthalmic artery in the right internal carotid artery. (c and d) Digital subtraction angiography showed a fistula (arrow) from the ophthalmic artery in the left internal carotid artery.
Figure 3:
Figure 3:
(a) Lateral view of a selective injection of the left ophthalmic artery presenting a fistula (arrow). (b) Scepter XC was placed distal to the internal carotid artery to stabilize the guiding catheter and microcatheter (arrow). (c) 20% N-butyl cyanoacrylate (NBCA) diluted with oily contrast medium was infused into the fistula (arrow). (d) Lateral view of a selective injection of the right ophthalmic artery presenting a fistula (arrow). (e) Scepter XC was placed distal to the internal carotid artery to stabilize guiding catheter and microcatheter (arrow). (f) 20% NBCA diluted with oily contrast medium was infused into the fistula (arrow).
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