Infantile Dural Arteriovenous Shunt Draining into a Developmental Venous Anomaly

Abstract

A three-year-old girl with an incidentally discovered infantile type of dural arteriovenous shunts (DAVs) along the superior sagittal sinus during investigation of a minor head trauma is presented. The DAVs drained into a developmental venous anomaly of the right cerebral hemisphere. In addition, there was a small cavernoma within the territory drained by the DVA. The patient underwent multiple transarterial embolizations to decrease the shunt flow and thus the constrained venous drainage of the DVA and right cerebral hemisphere. Pediatric dural arteriovenous shunts are a different entity from the adult type DAVs and should be managed according to the growth and development of the child. DVAs are extreme variations of the venous system with reduced flexibility to increased venous drainage. Regardless of the type of treatment employed, the DVA and its drainage pathway must be preserved.