Zhou Zibo, Yu Jinlu
Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin 130021, China.
Heliyon. 2023 Jun 1;9(6):e16907. doi: 10.1016/j.heliyon.2023.e16907. eCollection 2023 Jun.
Dural arteriovenous fistula (DAVF) of the inferior petrosal sinus (IPS) is very unusual. Endovascular embolization is a good option for the treatment of DAVF. Until now, DAVFs of the IPS have only been reported sporadically. We reported two such cases. Case 1 was a 48-year-old man with headache and diplopia. Angiography confirmed a DAVF of the distal IPS, mainly supplied by the occipital artery (OA), and the IPS was occluded, which retrogradely drained into the cavernous sinus (CS) and then into the cortical vein. The DAVF in case 1 was embolized completely via the OA to cast Onyx-18. Case 2 was a 69-year-old female who had red and swollen eyes. Angiography confirmed a DAVF of the proximal IPS, mainly supplied by the accessory meningeal artery (AMA), which drained into the CS and then into the ophthalmic vein, and the IPS was occluded. The DAVF in case 2 was embolized completely via the AMA to cast Onyx-18. After treatment, these two patients had uneventful recoveries. In our report, these two cases indicated that the DAVFs of the proximal and distal IPS shared different origins of feeding arteries. When the IPS is occluded, the transarterial approach via the main feeder, such as OA and AMA, can be feasible to cure the DAVF of the IPS.
岩下窦（IPS）的硬脑膜动静脉瘘（DAVF）非常罕见。血管内栓塞是治疗DAVF的一种良好选择。到目前为止，IPS的DAVF仅有零星报道。我们报告了两例这样的病例。病例1是一名48岁男性，有头痛和复视症状。血管造影证实为远端IPS的DAVF，主要由枕动脉（OA）供血，IPS闭塞，逆向引流至海绵窦（CS），然后进入皮质静脉。病例1中的DAVF通过OA完全栓塞，注入Onyx-18。病例2是一名69岁女性，眼睛红肿。血管造影证实为近端IPS的DAVF，主要由脑膜副动脉（AMA）供血，引流至CS，然后进入眼静脉，IPS闭塞。病例2中的DAVF通过AMA完全栓塞，注入Onyx-18。治疗后，这两名患者均顺利康复。在我们的报告中，这两例病例表明近端和远端IPS的DAVF供血动脉来源不同。当IPS闭塞时，经主要供血动脉（如OA和AMA）的经动脉途径可有效治愈IPS的DAVF。
