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Multiple Dural Arteriovenous Shunts in a 5-Year-Old Boy

Satoshi UshikoshiGo,a, Yoichi Kikuchia and Kazuo Miyasakaa

a From the Department of Radiology, Hokkaido University School of Medicine, North 15 West 7, Kitaku, Sapporo, Japan 060-8638.



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  		FIG 1. 5-year-old boy with developmental delay and multiple DAVSs.

A and B, T2-weighted MR images (3200/80) at 1 year of age show dilatation of anterior part of the superior sagittal sinus.

C and D, T2-weighted MR images (3800/85) at 5 years of age show dilatation of cortical veins (C), posterior fossa veins, and right superior ophthalmic vein (D).

E and F, Right external carotid angiograms, lateral view, arterial (E ) and venous (F ) phase, show an infantile DAVS in the anterior part of the superior sagittal sinus. Venous drainage goes into the right jugular vein and via the cortical veins into the cavernous sinuses. Severe stenosis of the right jugular bulb is noted (arrow, F ).

G and H, Left external carotid angiograms, lateral view, arterial phase (G), and anteroposterior view venous phase (H), show adult-type DAVSs in the left transverse sinus and posterior part of the superior sagittal sinus (arrowhead, G). Venous drainage goes into the cavernous sinuses via the basal veins, right jugular vein, and spinal perimedullary veins through the posterior fossa veins. Occlusion of the left sigmoidal sinus is noted.

I, Left internal carotid angiogram, anteroposterior view, shows a direct AVS between the middle meningeal artery, originating from the ophthalmic artery, and the anterior part of the superior sagittal sinus.

J, After embolization, left internal carotid angiogram, lateral view, late arterial phase, shows a small DAVS in the anterior part of the superior sagittal sinus (arrowhead) supplied by the anterior falx branch of the ophthalmic artery.

K, After embolization, left external carotid angiogram, anteroposterior view, shows an adult-type DAVS in the posterior part of the superior sagittal sinus, which was not treated, and complete obliteration of the DAVS in the left transverse sinus.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X