Venous Infarction Associated with a Sigmoid Sinus Dural Arteriovenous Fistula

Abstract

Dural arteriovenous fistulas with restricted antegrade venous flow and reflux into a dural sinus or cortical veins lead to intracranial venous hypertension. This type of venous hypertension in return may cause parenchymal damage by mechanisms similar to those proposed for venous infarction. A 42-year-old man presented with homonymous hemianopsia of the right upper visual field. Computed tomography demonstrated hypointensity in the left occipital lobe. Angiography confirmed dural arteriovenous fistula of the left sigmoid sinus, severe stenosis and occlusion of the left sigmoid sinus and reversal of the flow in the cortical veins. This fistula was treated with Onyx-18. This report emphasizes an unusual coexistence of venous infarction with sigmoid sinus dural arteriovenous fistula causing neurological symptoms.