Diagnosis and Minimally-Invasive Treatment of Posterior Fossa Dural Arteriovenous Fistula Presenting Clinically as A Carotid-Cavernous Fistula

Abstract

A posterior fossa dural arteriovenous fistula presenting clinically as a carotid-cavernous fistula is a very rare and relatively unknown situation. They present with several clinical symptoms due to abnormal or excessive blood flowing into the cavernous sinuses. Although abnormal shunts between two vascular domains near each other may be expected (as in carotid-cavernous fistulas), an abnormal shunt from a distant artery to a cavernous venous sinus would be something unusual. Endovascular treatment is now the first-line, safest and cost-effective treatment for this type of fistula. In this paper, we report a very rare situation (a spontaneous posterior fossa dural arteriovenous fistula presenting clinically as a carotid-cavernous fistula) that is treated with endovenous intervention and coil embolization. The importance of other cavernous sinus-related fistulas, their diagnostic features and therapeutic options will also be discussed in this paper.